The Impossibility of Sex: Stories of the Intimate Relationship between Therapist and Patient

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Overview

The conventional view of a patient in therapy has been that of someone who forms a powerful, erotic bond with the therapist. On the other hand, the view of the therapist has been that of a neutral listener, emotionally unaffected by the patient. But what really does go on within the sacrosanct space of the therapist's office?
Distinguished psychotherapist Susie Orbach provides the answers as she presents six stories of patients, all of whom suffer from such common afflictions as depression, loneliness, compulsive eating, consuming sexual desires, and fear of attachment. In each story, Orbach reveals not just the client's problems, but — with startling honesty — the effect the client has on her as therapist.
The Impossibility of Sex breaks new ground by taking us into the center of the therapy relationship, one usually shrouded by therapist-client confidentiality. From the unlikely role the therapist plays in the troubled relationship of two lesbians to the unsettling dreams the therapist experiences while treating a man consumed by sexual desire, Orbach illuminates the complex human interactions at the heart of the therapeutic process and the "joint discoveries" that contribute to its effectiveness.

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Editorial Reviews

From the Publisher
Courtney Weaver The Washington Post Book World An intelligent, thought-provoking collection of case stories...absorbing.

Stephen A. Mitchell author of Hope and Dread in Psychoanalysissis Susie Orbach brings alive the experience of actual psychotherapy with real patients in a rich, moving, searingly honest way.

Jeffrey Seinfeld author of The Empty Core The Impossibility of Sex is a pioneering contribution of dramatizing the therapist's side of the psychotherapeutic endeavor....Susie Orbach brings to life the essence of the authentic psychotherapy experience.

Publishers Weekly - Publisher's Weekly
Those who have ever surrendered themselves on an analyst's couch, or considered doing so, will want to read this vibrant book about therapy from the therapist's perspective. A seasoned analyst who was recently revealed to have counseled the late Princess Diana, Orbach (author of the '70s classic Fat Is a Feminist Issue) reveals what happens during therapy from the therapist's point of view with honesty, dashes of wit and a refreshing lack of sensationalism. Those who suspect that therapists sleep through their sessions will be gratified to find out how involving some find their patients. Orbach's examples (based on composites of patients she's seen over the years) fascinate but never read like case studies: Belle is a compulsive liar who moves from crisis to crisis; Joanna's distress threatens Orbach's sense of self by touching her deepest emotions; Carol and Maria are an interracial lesbian couple whose marriage counseling provokes Orbach to consider the role of trust and sex in relationships; Adam, an erstwhile Lothario, almost lures Orbach into his sexual web before she is able to help him relinquish his own libidinousness in favor of deep passion. Orbach elucidates the analytic process with verve, grace and erudition, invoking Freud and a host of other psychoanalysts while unveiling her own feelings about life, love, sex, passion and, of course, the therapeutic process. (Mar.) Copyright 2000 Cahners Business Information.|
Library Journal
Therapist Orbach (Fat Is a Feminist Issue) explains that the point of this misleadingly titled book is to convey "the feel of the relationship developed between the therapist and patient." Using six therapy case histories based on her real-life clients, she investigates their problems (some of them sexual)--which, from a voyeuristic perspective, is fun--and her own reactions, which are somewhat narcissistic and distracting. In the midst of the case histories, she also discusses psychoanalysis. Two different typefaces are used to distinguish the case histories from the digressions on psychoanalysis, and a third would have been helpful to offset Orbach's reactions. The concluding discussion of the female psyche is interesting but seems tacked on. Although somewhat confusing in execution, this bizarre little book is recommended for academic and public libraries, as the publisher notes that Orbach was Princess Diana's therapist.--Margaret Cardwell, Georgia Perimeter Coll., Clarkston Copyright 2000 Cahners Business Information.\
Lisa Jennifer Selzman
Orbach, the author of Fat Is a Feminist Issue, has a knack for making psychological material accessible and engrossing...The prevailing theme of this artful book is not the impossibility of sex, but rather the possibility of transcending violation and loneliness.
The New York Times Book Review
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Product Details

  • ISBN-13: 9780684864273
  • Publisher: Touchstone
  • Publication date: 3/5/2002
  • Pages: 256
  • Sales rank: 1,451,381
  • Product dimensions: 0.58 (w) x 5.50 (h) x 8.50 (d)

Meet the Author

Susie Orbach is a cofounder of the Women's Therapy Centre in London and a visiting professor at the London School of Economics. Author of Fat Is a Feminist Issue, she is also a cofounder of the Women's Therapy Centre Institute in New York. Orbach lives in London with her partner and two children.

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Read an Excerpt

The Vampire Casanova

I felt twitches in my vagina, pleasurable contractions. It was a sunny Sunday morning in spring, two years after I had stopped seeing Adam. I was chopping some fennel when he not so much entered my mind as tapped on my body, as he had so many times during the course of a five-year therapy. Adam was a chef and from time to time when I was preparing food, his presence would insinuate itself and I would be back in the physical ambiance of our therapy time together.

Adam was a fornicator, a lover, a stud; a man whose daily life was shaped by sexual desire and sexual conquest in a spiral of infatuation, seduction and vanquishing. There were never less than one love interest and two or three gorgeous "girls" on the go, not of course counting on the previously conquered, who would return for occasional trysts when they were in town or between boyfriends.

The year before he embarked on therapy the then 36-year-old Adam developed a problem that jeopardized his perception of himself. He had started to ejaculate too soon. Desperate to make the problem go away, he came to therapy. "Too soon for whom?" I asked. "Too soon for me. You know, too soon for me to really give it to her. To fuck her real special. Like no one else. Take her places she's never been."

The imperative of his sexuality and the potency of his penis fascinated me. It was so present and insistent that I felt swept back twenty years to before my generation's encounter with feminism thought it had remade sexual relations both in and out of bed.

What did coming too soon mean to him? That it wasn't complete? That his orgasm was a squib rather than a release and a connection? Was he anxious? Did he have to concentrate too hard on giving to the woman? Was he insecure?

"All of those, sure," he said on his first session. "See, I really love women," he said, slowing down as he realized he was sobbing. "Take Sarah who I was with last week. Now she's something special." He paused another second. "While I was romancing her, I really believed, you know, that I loved her."

Before self-reflection could count, before he could register how hearing himself was a new experience, he pulled himself out of his pain and slowly spoke what would be ours to sort out over the next few years.

"I'm a physically passionate man," he said as he looked into my eyes and mimed Me Tarzan, You Jane. "It's just nature. But something is getting in the way of mine. So, figure it out, Doc. Come on. Without fucking what's the point. Fucking is my life."

The bluntness of his words and the flip between Southern American formality and crudeness jarred with the softness, almost a sweetness, in his persona. I wondered about the clash.

Adam began to tell his story. Although few feelings came through, the preliminary shape he gave his life had a certain coherence to it. He was born on Long Island in the working-class community of Huntington Station shortly before the end of the Second World War. His father and mother had been childhood sweethearts and she had become pregnant before he went off to serve in Europe. The photos Adam had of his father in uniform and the stories his mother told about him portrayed him as an eager, if somewhat naive, young man, ready to serve his country and see a bit of Gay Paree. War was a romantic moment rather than the reality of bombs, scarcity, cold and death. While he was stationed in England, Adam's father got involved with a Yorkshire woman, who also became pregnant. He promised to take her with him to the United States (Adam often wondered if his father had entered into a fraudulent marriage with her). On returning to New York, Adam's father moved in with his mother and him for a year but when it came out that he had fathered another child, there were terrible fights and eventually he left for California. He kept in sporadic touch with Adam for a few years, coming back once for a few months when Adam was six, but his father dropped out of his life after his eighth birthday when he turned from being a heroic husband and father to a maligned bigamist.

Adam grew up very close to his mother. He was her companion, her little man. At twelve he was making decisions for the two of them, carrying the money she earned as a beautician, telling her how much they could spend. They moved around a lot, from New York to Florida and then around the state, either to catch up with some new man she was after or chasing a job opportunity that did not quite pan out. He learned to make friends quickly and to let them go easily. He was distracted from the pain of his dislocations by the abundant dramas his mother wrought in their lives.

At seventeen, after finishing high school in Vero Beach, Florida, Adam went back to New York, tried butchering, his father's trade, then acting and moved on to selling art and doing exquisite dinner-party cooking. He found his way into a glitzy social scene and discovered how sexy he could be to neglected married women. Wonderful at paying them attention, knowing what they longed for and dressed like a man with twenty times his income, Adam became extremely desirable. In 1972 when he was twenty-seven he married Elizabeth, a wealthy divorcée.

Elizabeth misconstrued Adam's pursuit of her as true love (which it was at the time) and she was crushed by his philandering. She divorced him quickly, giving him enough money to start a restaurant. Designed by a friend, hung with paintings on loan from artists he used to represent, and given sufficient publicity as New York's coolest restaurant just at the time when food and eateries became a leisure pursuit of a large segment of New York's middle class, his restaurant soon took off. He became a respected chef and restaurateur. Meanwhile, his mother, who had moved to New York to be nearer to him after a failed love affair, died of cancer at the age of fifty-five.

Before Adam came to see me in 1980 his life was shaped by two preoccupations: being a celebrity chef — rushing around judging competitions, doing guest-chef stints in other restaurants, creating beautiful tables for photo shoots, writing a cookbook with his assistant — and having girlfriends, dozens and dozens of them.

His hectic life and pursuit of women worked well enough for him. He felt gratified by the attention he received, pleased to be the consummate lover and part of a glamorous set. There was plenty of excitement. He was always living in a mini-drama, often of his own making, where one or two of the women he was sleeping with would be on the verge of finding out about another. Concealment and the fear of discovery excited him enormously. I thought of the analyst Winnicott's observation: "It is a joy to be hidden but a disaster not to be found" and wondered what it foretold of what needed finding in therapy.

The scrapes Adam got himself into and the tension of his many work commitments helped him feel valued. He was clearly needed by others. If he had not hit this problem of early ejaculation, he never, he assured me, would be seeing me. "Everything was coming up roses till that point. Hell, I wouldn't have been here sitting with you, ma'am. I'd a been making you sweet sweet love." Extreme intensity exuded from him even in this play tease and I could sense how compelling the turn of his attention to a woman might be.

His discomfort in seeking help from a woman after many years of looking after women in one way or another was pronounced. He was awkward as he tried to give a fuller account of himself, to show some vulnerability, not to be the big guy who was always in charge.

Yet he settled well into therapy. He was relieved to be able to talk about his life, the ins and outs of his love affairs and the emotional patterns he wove. As we got to know each other better, more details emerged about sex and loving. He now frequently sought a different kind of sex, a more violent encounter teetering on the edge of bondage and rape. His sexual fantasy life had moved in that direction when he started to come too soon, and he had discovered that while masturbating he could sustain his excitement long enough with a violent fantasy to give him a satisfying orgasm. It did not work when he was actually with someone. With a woman, however much he wanted her, he felt precarious, anxious and that he "came too soon."

Adam was indeed a sensual man. I could feel it in greeting him. When I put out my hand to shake his on our first encounter, the presence of his hand stayed with me. After he left the consulting room, his smell was in my nose. When he stood up to leave it was as though the room were being emptied. When he talked about women, I could feel his love. Clichéd words which I might have tended to laugh at if they had come from a friend took on a lush, rich tone. He found women miraculous, beautiful, sexy, delicious and inviting; their movements, their smells, their pretty lingerie draped nature with tenderness. His open appreciation and joy gave me a new perspective on my gender's sexuality and I could almost see women from his perspective as wondrous, luscious, magical, holding secrets desperately worth penetrating.

He was nothing if he wasn't a lover, he said. He needed to pursue, to please, to have a woman's pleasure in his sexual capacities reflected back to him. He wanted to get to the heart of women, emotionally and sexually, so that they would be forever transformed by his touch. And they were. His intensity, interest and sexual certainty made it possible for his lovers to open up, to feel as though they were discovering their sexuality as adult women and to go where "they'd never been before." But despite his and their evident satisfaction and pleasure, Adam was always on to the next encounter, the next woman who could confirm him, who by opening her legs and her heart would make him feel he existed. Until his sexual problem.

The sexual problem that so dismayed Adam brought to a stop his habitual way of going about life, his way of understanding himself, his way of being with a woman, his way of giving and receiving love and his way of feeling good. All that he knew about himself was now thrown into question. In choosing psychoanalytic therapy, he was embarking on a journey to make some sense of the way he organized his emotional and sexual life, to question what motivated him, to fathom why his penis was forsaking him, to connect up, as he might say, with his emotional heartbeat.

While Adam was desperate to get his penis working for him again and had consulted physicians about techniques to forestall orgasm, he found that he was curiously relieved when I suggested that his "coming too soon" might hold clues about aspects of himself that as yet he did not recognize.

The issue of symptom relief has always been a thorny one for psychoanalysis. In Freud's work it was the symptom, principally the hysterical, non-organic symptom that disabled the individual in many different ways that psychoanalysis at first sought to comprehend. Anna O's tortured limbs, Cäcilie M's paralysis and the widespread phenomenon of physical anesthesia were the material that Freud and Breuer drew on in 1895 in their groundbreaking Studies on Hysteria. Since that time psychoanalysis has swung between treating symptoms and interpreting them as metaphors, regarding them as manifestations of unconscious processes. Sometimes psychoanalytic patients have been relieved that in the analytic space they can speak of whatever enters their minds, that they need not slot everything about their experience into the narrow confines of their symptom. Sometimes they have been alarmed because their symptom, despite a most thorough analysis, remains entrenched. Clinicians walk an uneasy line between addressing the symptom per se, giving the person space to talk about it and how the symptom expresses, disables, enables and enunciates aspects of the individual, and at the same time offering the possibility that there are other ways of experiencing that the patient may not be allowing herself to acknowledge.

Adam was quite interested to know what stories he had invented for himself about his magical phallus and why, if it was so magical, these powers had now deserted him. He could see at once that his self-conception as a lover was a lens through which all his experience passed and although part of him longed to be free of sexual anxiety and to return to the status quo, he was intrigued by the notion that there was something to know beyond his symptom and perhaps beyond his sexuality too.

It was not long into the therapy before Adam registered that I was a woman. Since his only repertoire with women was either to look after them or make love to them, seeing me as a woman put him in a quandary. Interested as he was that I be the doctor in a metaphorical white coat who would help him examine his life, he could not keep me in that category. He had to flirt.

It would be inaccurate to say that he would flirt when he was anxious or to fill the space or, as happens in normal social life, as a way of smoothing over those awkward moments that can occur between women and men. No. Such a description would strip Adam of his essence. Adam was flirtation incarnate. He could not help but flirt. When we first met, this flirtation had been expressed as charm. As his therapy continued, however, he beamed his seductiveness toward me and the analysis of it, including his active sexual pursuit of me, became a central feature of our sessions.

For a few months Adam and I explored the life of his penis. Through this valued part of himself he felt able to give and receive love, to make women desire and need him. His penis, he felt, let him convey to a woman that he was interested in her emotionally and sexually as she had never been noticed before. The intensity of his appeal, the promise he held out that he would reach and move her, spiritually and sexually, became irresistible. A woman who gave a hint of returning his interest would receive an emotional assault that not only had her longing for him but left her feeling that without his attention she was somehow lost.

As I listened to his accounts of seductions I felt acute sorrow for Adam in his fierce search to connect. I felt scared too for the woman he was currently after. I would not have wanted to be in her position. I could sense that he picked his women up in one place, twirled them around and then pulled them inside out, so that when they were dropped they had been through a sexual and emotional revolution that left them reeling as they tried to pick up the pieces of their pre-Adam selves. Although he played it as a game — game, set, match — it was the women who would be knocked out by him. He could always go on to the next conquest, the next woman who showed him how much she desired him.

In pursuit of a woman Adam was alive. Although he was aware that his encounters had a predictable pattern of pursuit, seduction and loss of interest, the chase worked for him. Adam's well-being, his sense of self, his raison d'être required a sexual quest, the challenge of teasing and coaxing the heart of a woman to open up so that he could capture her. When he secured the woman he was desperate for, there was a moment — sometimes a longish moment before his interest dissolved — when Adam felt loved and accepted.

He knew that he was sexually appealing. His distress over coming too soon humiliated him. It humiliated him that he had had to come to see me. By flirting in therapy he was bringing forward what he felt to be the best of him, inviting me to be entranced by those aspects of himself that he esteemed, so that as we entered into the not-so-nice bits, he was reassured that I could see his charm and accept him.

At first his flirting tickled me, somewhat as a teacher might feel at the predictable unfolding and development of a student she enjoyed. I had been flirted with in the consulting room before. I could anticipate that something of Adam's flirtatiousness would enter our relationship and, remembering Freud's injunction to analyze rather than take personally the professed love of a patient, I was not much worried about this entry of the erotic into the therapeutic space. It was not that Freud thought that the entreaties of a patient were disingenuous or unworthy but that we could learn much more about the patient through applying ourself to understanding the entreaties. Freud's caution to the analyst was that such seductions were an undeserving love, a transferred or transference love (from a parent to the analyst). Such love clothed that which must be uncovered if psychoanalysis was to be of value. The analyst need not be flattered by, or taken in by the sexual displays and exhortations of love emanating from his female patients. "He has no grounds for being proud of such a 'conquest,'" Freud warned.

So I was not surprised when Adam came on strong. He had been able to tell me that without the pursuit of a woman, he felt cavernously empty, as though he did not exist. I could imagine that at some point in our sessions I might briefly become the object of his desire. That, when or should this occur, I would be pointing out to him how his flirtation or desire could steer us in the direction of understanding what it concealed. I was surprised though by how strong and how explicit his appeal to me was.

"I have to make love to you," he said. "I need you more than I need therapy. It's killing me coming here session after session dreaming about you, thinking about you, smelling you — your sweet body smell and your perfume." He was really revving up now. "I imagine caressing you. My hands between your silky legs, my body aching, desperate to be with you. I know you feel it. I know you want me. I know you're just holding back because you're my doctor. I know you are."

No, Adam, that's not quite right is what I was thinking, but as he was declaring his desire and I was formulating my response I could feel my body tingle, Freud's injunction notwithstanding.

"You don't believe I'm for real because I told you about all those other girls. But this is different. You know it. You can feel it. I know you can. We'd both be missing something we've never had before if we said no to it. This is big. Something that comes round once."

I said nothing. I thought about Adam and his mother and how confusing it might have been for him to be her little man. I thought about how hard the renunciation of his childhood sexual desire for her might have been for him when she treated him so much as her partner rather than as her son. The togetherness he craved, the being reached and reaching out that were his refrain with women, could have been too tantalizingly for him. I wondered about her seductiveness, how much sexual play had passed from mother to son to bridge the gaps she felt in her sexual and emotional life.

My thoughts were intended as much to calm me down as they were to analyze the situation. This was not a little flirting around the edges but Adam's powerful declaration of desire. I was being given the treatment.

The problem for me was that I was not unmoved. I found Adam's entreaties attractive. I talked to myself in an attempt to slow down the emotional steamroller coming at me.

"I've never opened up like this," he continued in an approach modified to turn on a psychotherapist. "I've never been touched like this. No one has ever let me find myself before."

"Perhaps you're feeling some relief, sensing that it is possible to be understood more fully instead of having to rush in and out of relationships looking for some brief magical contact," I said, hoping that a bland comment could slow time and defuse the erotic.

Adam steamrollered on. "I know you think this is me doing my number but you've got to believe me. I've never bared myself before anyone else. All my honesty before was bullshit. My nakedness was a sham." I could feel him shifting into his Southern gentleman mode as he continued. "I thought I was bringing myself to the other person but it was a pretense. Listen to me, will you. Don't analyze this all away. I'm serious. Really serious. I want to, I have to, make love to you."

As Adam beamed his interest at me beyond the come-on line, his insistence, his passion, his desire was palpable. I was his prey. I could almost watch it happening in front of me except that I was part of who it was happening to. I could tell I was going to have a hard time with it. If I did not take it seriously, the therapy would be ruined but if I took it too seriously, the therapy would also be ruined. I was going to have to find the line to walk. Was I in danger, like his other women, of being tossed up, twirled around and then spat out?

I could sense him getting under my skin. I tried to analyze what was going on, to understand and to calm myself. This is nothing different in kind, I reminded myself, from the emotional places I have been to with other patients. It is different in quality because this is about sex and the erotic. I am feeling scared but if I do not get to what this is for him, if I do not take my experience as a sounding-board — a version of what he is feeling, needing or has felt — then as a therapist I am letting him down.

I said this to myself, hoping that by formulating it this way I would be able to keep my vision clear. I would be able to feel his attractiveness, what drove him and pulled women to him in a way that was useful to him. If I was not to believe this would happen in the course of my becoming awash in the effects of his seductiveness, then I would have had to stop being his therapist. And although I considered that option, it was too naive and clinically irresponsible. Adam was doing what he needed to be doing, what he could not help but do. If he could not act in his therapy the way he did in the world and so have this behavior understood, there was little hope that what troubled him could be grappled with.

The genuineness of his appeal landed on me much as it had landed on the dozens — no, the hundreds — of women he had bewitched before. While most of my channels were caught up in his appeals, an observing channel remained open. As I felt drawn by his allure, I was fascinated by how incredibly sincere and authentic it felt. It was as though his whole being exuded something utterly appealing. I saw and felt that I wanted to love him. The divide between the thought and what might happen felt precarious. He pulled on me in some irresistible way. The opportunist Casanova I had imagined him to be when he had talked earlier about his capacities as a romancer was effaced. Instead there sat before me a beguiling mixture of an eager virgin heart and a self-confident lover. So this is what hooks his women, I thought, even as I felt more than flattered and pleased by his attention.

I went to bed that night full of Adam. He stayed with me through the night so that when I awoke I was not sure whose bed I was in or who was in mine. My senses were sharpened as they can be in the throes of an infatuation. As I went about the pedestrian tasks of putting fresh flowers in the consulting room, reading the morning's mail and processing the news, I thought how wondrous life can be. When a friend phoned about some plans for the evening and heard an unfamiliar lilt in my eight A.M. voice her inquiry about my good mood made me try to get a hold of myself. Just where was this singing inside me coming from? Was I letting the countertransference — the feelings the therapist has for the patient — get a bit heady? I chuckled to myself. I was not prepared to give up the good feelings so hurriedly. So much of the psychotherapist's day is spent entering painful places, processing anxiety, buffeting the sorrow, anger, confusion and terror that patients bring. I went into the shower and as I let the water run on my body, I felt with pleasure its silkiness, the sensual flow of the water's pulse from the showerhead on to my body.

All at once the image of an enormous showerhead in a hotel bathroom I had glimpsed years before melded into a picture of Adam and me making love. He was trying to touch an erotic part of me that had never been awakened. I found myself smiling, even blushing, as I realized how exquisite, but also how ridiculous, it felt. I was in a state of sexual reverie, no doubt about that. Could I trust it to stay there? Every therapy is an adventure, I told myself. Unpacking it was part of the job, feeling it enough to know what was going on.

Ten percent of patients are vulnerable to sexual advances from their therapists. It is not only therapists leaping onto their patients that creates such a worrying picture, but also the danger that Freud highlighted of how an erotic transference encourages a therapist to act on rather than to analyze erotic feelings which can lead to an abuse of the therapeutic situation. To protect patients, therapists until recently felt it best to deny or sidestep their arousal but, if it continued, to rush back into therapy themselves and to case supervision to sort themselves out and to untangle the particulars of a case in which they felt the threat of becoming unprofessionally ensnared.

This undoubtedly helpful protocol is mandatory for a therapist for whom sexual arousal during the course of a therapy is not a single experience but a habitual trouble. However, alongside this minimum protection for the patient, a body of thought has begun to emerge over the last decade suggesting that a therapist who finds herself aroused might best help her patient if she can become less afraid of her responses and keep herself consciously aware of them long enough to think about them privately. Indeed Michael Tansey suggests that it is precisely analysts' fear of their own sexual feelings toward their patients that needs to be addressed so that the erotic transference can be explored. If analysts cannot countenance such feelings within themselves but suppress or deny them or separate them from conscious awareness, there is a much higher chance of inappropriate sexuality being unwittingly enacted in the therapy. This danger is decreased if the analyst can think about erotic feelings for a patient (and what they signify) without fear of censure.

Although part of me envisioned professional reproof for the thoughts I was having, another part of me knew that I had to go on with this exploration and receive the feelings I was having as part of the treatment. Bodily sensations were as valid and useful as any others. It was just a question of holding on long enough and being alert enough to the idiosyncrasies of this arousal to untangle the bits that belonged to me personally from those that emanated from or were created between Adam and myself. The important thing, I told myself as I stepped out of the shower, was to be aware of any desire on my part to exploit the situation for my own sexual ends. Was being wanted in this way a buzz to a woman in a long-term relationship, used to great intensity but removed from the insistence of early sexual passion? If this was the case, and I knew I would have to question myself hard and honestly here, was I unconsciously encouraging a flirtation with Adam? Did I need him to confirm some aspect of my desirability?

Ugh. I did not much like that thought. If it was accurate I would have to take special care of what message I was sending Adam. Did I have a wish to be found desirable? Was this the chink of receptivity he had referred to in seeking women? I was not seeing Adam today. I had time to reflect on myself later. For now I focused on what I thought Adam was up to.

In one way Adam was taking up residence inside me in the manner he did with others. I accepted that this was his way of being attached. I recognized that in privately surrendering to his flirting I was wrapping myself up in his idiom. It was a way of speaking his language, of becoming close in the way that he could. That might be how he would be imprinted on me for now, just as other patients with a different psychic grammar would become emotionally imprinted in their unique ways. As I realized this I let his flirting stay with me. If this was the way he was finding a psychic home with me, so be it.

I went about my sessions that day grateful for the ones in which the engagement was more straightforward. That night I went through a list of the unexpected emotional journeys that I had been swept up in during years of being a therapist, journeys choked with difficult, powerful, unpleasant feelings.

I recalled the times when I felt hated. Unable to provide what a patient felt she needed from me, and unable to repair the horror of her past, I felt her hatred of her parent blending with her hatred of me and I became a useless, contemptible punching bag. The discomfort of that had been as hard to bear as the occasions when I felt dropped, jerked around or intensely needed.

I also remembered times when I felt clinically lost, when my brain scrambled, when I tumbled into another's psychic world not sure that I would find myself and my psychic footing again and having little to hold on to except a certain knowledge of the inevitability and the necessity of it all. I reminded myself that the therapist's lot is to be both in the place that is demanded by the patient while being able to recover oneself. I knew I needed to be affected, to be disturbed, to experience something of the patient's psychological state. I had always recovered myself and I had learned that it was an easier ride if I allowed myself to register rather than resist the pressure exerted on me in the therapy relationship. That way I was responding to only one emotional assault at a time. To have interfered by resisting would have doubled my confusion.

At least, I consoled myself, I had an inkling of what this emotional journey might entail. Adam had been so forthcoming about what he did with women, I had such a graphic picture of the way he picked them up and spewed them out, that I was well forewarned. If I were to surrender to his exhortation, not literally but inside myself, then I had a fair idea of the territory. It was not going to be a mystery.

The session following the weekend, Adam started right in. He had spent the weekend making love to Laura while thinking about me. Some love, I was thinking mockingly, rebuked by my own conceit. But before I could let myself off the hook, Adam's seduction took on a particular twist.

"The thing is this, Doc — and I know you can't believe that I'm getting into someone else's panties if I love you so much — the thing is, listen, please listen, 'cause this is weird. I could come right and I could be with this woman long enough because, because of what's happening between us."

In case I was slow to catch on, he repeated himself, refining it as he did so.

"Listen, I'm saying something about how you've helped me. Sex was what it was meant to be. The only thing was I wasn't making love to Laura. I was making love with you."

My mind rushed to interpret. Well, of course, that made a certain sense. Since he had lost his mother, his love felt unsafe. He might be engulfed by another woman. His attachment to his mother with its sexual taboo kept him relatively protected. He could love his mother and be sexual with other women. While it was not wholly satisfactory, at least he was not overwhelmed. He did not have to deal with his erotic feelings toward his mother (or hers to him). He could stay emotionally loyal to her, not desert her by ever really loving someone else. But when she died, this compromise had collapsed. He had had to sever the erotic lest he become smothered. Now I was a stand-in for his mother. His attachment to me mimicked aspects of his feelings for her, except that with me he could get a step closer to exploring the sexual.

I told Adam what I thought might be going on. I was not sure if I had a hold of something central for him or whether I was simply relieved at the clarity (however temporary) this brought me. At least my sexual feelings had evaporated and I was back on my feet.

Adam rejected my thoughts. Or rather he took them as a rebuff and, starting up his sexual motor, I got the full works once again.

"Hey, Doc, watch out! Don't hide behind the Freud stuff. I was trying to tell you that you're really helping me. Our love is making me better. Hey," he added, flipping to a direct physical approach. "Cute boots. You're looking great today."

I felt weary at the thought of the attempts I would be making over the rest of the fifty minutes to see what was under, inside and wrapped around this sexual bid for me and his focus on what might matter to or move a woman.

"Your attention to me, how I look, what I am wearing and how quasi-helpful I'm being, has a real intensity to it. It's as though you scan to get what will touch me and then pull me close to you."

"Yeah, Doc. Sure I do. That's what love means. You got a problem with that? You're one beautiful lady and I want you."

There was something about his Southern way of speaking that turned me right off. I was grateful for that and went back to the slog of trying to talk about his weekend with Laura and his feelings of attachment to me. I was not altogether successful because as long as I refused to speak through his metaphor, the distance between us grew. And while Adam would in time need to experience that space between us, I sensed that as yet he could not bear it. He could not approach the void. It was too difficult. He'd rather go for a tussle with me and continue to try to make the conversation sexual. To bring back the tease. To make our contact sing for him in that way.

He yanked one way and I yanked the other. Several sessions proceeded in this manner. He would make a flattering comment about my appearance or the way I said things. I would try to get behind or beyond those words to what else he might be saying. Enraged that I was not taking what he said at face value, he continued to beseech me, to tell me that the only reason he was coming to sessions was to court me and then we would fall into silence.

For ten months the therapy was on the edge. It teetered between his insistent, attempted seductions of me and my equally insistent position that we had to understand why he was so caught up with me, what he would be feeling if he were not, what we might be able to address in therapy if he could be with me without having to sexualize our encounter.

By challenging the sexual nature of his interest and attachment to me, I was denying the essence of him, he felt. While he battled to seduce me, I battled to make him face his emptiness. I felt cruel, almost callous, in my pursuit of what I felt he needed to do clinically.

Of course I discussed endlessly why Adam now found himself so caught up with me. Of course I tried to see what this "falling for me" was a panicky reaction to. Of course I repeatedly analyzed and suggested what I thought might be going on.

A lot of the time I stayed quiet. I needed to reflect on what he was saying, what I felt I was trying to say to him, and what I was feeling. My working hunch was that he was scared of contact with a woman that wasn't sexualized, that it made him too vulnerable, put him in touch with feelings of dependency, of rage and engulfment which lay at the core of the difficulty he had brought to therapy. I did not want to desexualize and reduce what he was expressing to infantile longings, but I felt strongly that if he could only get to those feelings, rather than divert himself with erotic play, we could address the difficulties he had faced growing up and transform the legacy they had left him — a legacy in which he was unable to own up to his rage and hatred of women, his fear of being dependent on them and his fear of being taken over by them.

I had an outline of how I thought the therapy might proceed if I could only get it on track. I juggled where I thought the treatment needed to go with my attempt to be open to where it was going. Resisting his insistence that we play in the erotic had merit, I felt, but I noticed that even our tug of war about where the work was to go had started to take on an erotic aspect too. In my rejection of his sexuality I feared I was dangerously close to the edge of sadism. Mindful of his recent interest in sadomasochistic sex, I wondered whether whatever I offered would be retranslated into the sexualized language he felt safe in.

The therapy continued in this manner. I wanted to find a way to extend his emotional repertoire so that other forms of contact could touch him. I made silent interpretations of his behavior. If I thought they would be useful I articulated them. Much of the time I was quietly trying to be with him, not be rattled by his sexual come-on and not reject him. I was caught in a bind for the way I could stay with him through the sexual onslaught was to do the very thing that infuriated him — transposing his sexual idiom into one I could work with. I hoped that by showing him it was possible to survive the anxiety I believe his sexuality covered up, he might find some confidence to approach it. I felt rather like a tired old schoolteacher insisting that the unruly children stay in their seats instead of running around the classroom. I was doggedly maintaining a boundary that was not to be crossed. But just as it would be for the pupils, what I held out for him was of doubtful pleasure or benefit. Running around was so much more fun.

The killjoy in me made me question myself further. Was I just a dreary middle-aged woman who would not play? Was I excessively rigid? Was I like those withholding therapists who refuse to enter into their patient's world and so leave the person stranded while they complacently rely on theory to keep them going? Maybe Adam was right. Life was dead boring without passion and crises de coeur. I had enjoyed the frisson between us just a few months back. Why was I pushing the richness of ordinary relating when it was manifestly so thin in comparison? Was I settling for emotional steadiness and some theory about how to live rather than embracing life?

I thought back to when I was younger, when my life had been much more on the edge, when I had been on the lookout for emotional adventure and was game for so many risks. Was I really sure I preferred my existence now or was I just rationalizing its staidness? Had I, without noticing the downside, dried up, deadened myself into defensively using my understanding of psychological processes to pin me down and keep me in one place? Did I look ruefully at women my age who were still adventurers before quickly comforting myself with a dose of smug maturity?

I did not really like this confrontation with myself. I felt I was sorted at a fundamental level. I did not want to be disturbed in this way by Adam. I did not like the challenge he was setting me. I knew the challenge was as much about him as it was about me. I knew that he needed to come up against me and find me steadfast. But I also knew that for me to be authentically firm, for me to genuinely get to what was behind his sexualization of our relationship, I had to experience and explore what he was throwing at me, not only his seductions but what his erotic play for me and my response to it said about my life.

One weekend I fell ill and went to bed with a fever in the afternoon. My family, taking care not to disturb me, left the house. In the unusual stillness I found myself fantasizing a different life, a life in which neither my family nor my work kept me tied down, a life that held a spontaneity different from the one I had become accustomed to. I found myself thinking about Adam and the hotel shower once again. I imagined telling my family I would be away the following weekend and then going to spend it with him.

The thoughts frightened me and, combined with my fever, made me not quite sure what was happening. I called a trusted friend and colleague to talk it over. A bit of supervision was what was required. Was this fantasy any different, I questioned myself, from the imaginings I had about another patient — to wrap her in a blanket and take her home? Was I insisting that Adam's erotic play was distracting us from more substantial issues because I was scared of being entangled?

I reminded myself yet again that a surrender to the psychological magnetism of a patient paradoxically strengthens the pull to recover oneself. I knew from experience that the less I opposed what might happen inside me, the speedier I would "refind" myself and be able to give back to Adam something useful that arose out of my emotional "surrender." I reassured myself that even as I slid along with Adam's seduction and became caught up in it, there would be a sliver of an observing eye looking and thinking about the experience I was having in a way that would be fruitful to him.

The next Monday there was a change in the session. Adam was not much interested in me. He was polite and solicitous but his energy was not relentlessly engaged in making me feel I was the only person who existed for him at that moment. Although I was extremely interested in the change in him, I was also disconcerted, since after the ten-month barrage I had finally allowed him to seep into me in the way he said he wanted to. Was there a concordance here between my taking him in sexually in my mind and his no longer needing me? Was this exactly what always happened with his lovers? He would lose interest when he had fully captured theirs. Once a woman really wanted him, his desire for her waned. It was the play that got him going, the conquest. A woman's surrender was her death knell. She would want him but he would no longer be interested in her.

The observing part of me smiled. It is often the case that when a therapist makes a shift inside herself because she has understood something about her feelings in relation to a patient, or allowed for some possibility, that wordlessly, almost miraculously, the atmosphere changes. The part of me that had been caught up but had then finally let myself to go the hotel to have the affair let Adam off the hook. Once assured he was wanted, he could move on. By my wanting him, he had something of me inside him. He was not as empty and his desperation was stilled. For the present. Now the therapy could move forward. There was new information, new data to consider. The essential piece of him needing to be wanted, of having physically to conquer me, had now happened between us. What I was feeling might be a crucial insight into Adam's inner world, a part of himself that was either hidden under the pursuit or split off and projected onto his victim.

As Adam withdrew his interest from me, I was relieved to see that the sexual buzzing he had stimulated in me stopped. There was a slight sense of loss. I felt a little wan but my dominant feeling was one of relief. I felt eager for the new gear I hoped the therapy and our relationship might shift into.

But I was too quick to feel this was a breakthrough. Over the next few sessions as the sexual agenda expired in me, it got restimulated in him. I wondered whether I was going to be trapped in some paradoxical play in which if he did not come on to me sexually, I would have to be privately drawn to him. I was exasperated. Now he was flirting not only in every session but for almost all of the session. I could not quite place how I felt. There was something peculiar about being paid to receive sexual flattery for fifty minutes several times a week. There was also something harassing about it. More annoying was the fact that over the next few weeks Adam's sexuality found its way back to disturbing me and I found myself fantasizing once again.

Having been there once before, I wondered whether there would be a replay of what had occurred weeks earlier. Would it be that as soon as I took his sexual bid for me seriously, it would evaporate for him? Would I repeat the experience of both letdown and relief? Would Adam once more, after a few more sessions of sensing my withdrawal, come on again? I wondered how many rounds we might have to go like this, punching and blocking.

As I allowed myself to consider Adam as a lover, I felt his force, his strength and his desperateness. As I entered the fantasy, I dimly felt that I was not being invited to have a relationship with him, to create something with him. Sure, I was going to be given lots of attention but there was a deeper feeling: I was being asked to receive his intense hunger and desperation, to open myself up to be used by him. I shuddered. It was what I had formulated for myself theoretically but until this moment I had not really known or felt it. I had a glimpse of the way he picked up, hollowed out and rattled his women while staying slightly at a distance. Although he appeared present, sexually attentive and desperately wanting, a chilling absence stood where relating might have been expected. I wondered if this is what he had always felt with his mother. I wondered whether he had felt used, toyed with, rather than related to.

And yet while I could analyze the way he seemed to bore into me and even feel how disagreeable it was, it was not the only feeling. I was also drawn in, fascinated. Out of the desolation that I felt in surrendering to the fantasy, I felt the coldness at the heart of his seduction. My desire to reach him emotionally and transform what seemed like a steel rod at his core was aroused.

By now it was spring and Adam went away to judge food competitions in France for two weeks. During that time I kept a warm feeling for him and I missed him. Before he left I had felt something of the terror and isolation of his disturbance which would enable the work to proceed. I was looking forward to his return.

When he came back, he was incredibly offhand. Predictably, his interest in me was extinguished. Not only had I been aroused — which perhaps he had subliminally picked up — so he was not compelled to chase me, but more significant perhaps was how he dealt with his attachment to me in his absence. Without me there to represent it and literally embody it, our relationship was of no value to him. It was because he found his needs so overwhelming and so hard to tolerate that he had to be on the lookout to have them related to every second. Since he could not trust our attachment (or any other), he would transfer his hungers elsewhere to where he might get the sense that he was not flayed by them but was instead having them responded to. I was sure, and he confirmed it, that he had had umpteen liaisons while he was away.

My curiosity and my feelings about these other liaisons did not surprise me theoretically. But emotionally I felt betrayed. While I had been hanging on to our attachment enough to taste how abject his inner experience was, how desperately needy he was, how the steel core at the center of him made him unable to really love or use the love that came to him, and how much I hoped that our sessions could hold on to this truth, he had disappeared.

It was as though I had been scooped out and vampirized. My insides had been all stirred up with no place to go. I recognized myself in the description of my patients who had been at the receiving end of Adam. Now I too felt that I was in need of something from Adam that I had not needed before, something he had tantalizingly promised would be met and which he was now withdrawing. I felt sick, foolish, ridiculed.

Fortunately I had the framework of therapy to steady myself. I set my energies to thinking about what I had experienced. I had an image of him climbing into me, creating a cavity through the center of me and then banging his fists on my skeleton from the inside. I felt colonized and as though he were eating me up. In the sessions his flirting, with its charm and sweetness, had been predominant. Now I felt him swooping in on me like a vulture.

I felt sick inside but also clearer about the work. I needed to find a way to bring out some of the feelings I had experienced with him to see whether they were a version of the horror he was always trying to escape from. My hunch had been that a dreadful emptiness sat inside him. What I was not clear on was where the vampirizing came from. He was so practiced in this behavior, so intent on sucking something out of the women he landed on and in, that I felt he might be trying to solve something that had happened repetitively to him early on, so that it had become the salient emotional experience for him. I conjectured that in his actions he was trying to gain a kind of mastery over the experience of having been swooped on by now becoming the agent rather than the victim of the swoop.

As my understanding stopped my sexual desire, Adam's flirting started up again. But with a distaste for what had happened last time, I was not to be rattled. I directed the conversation to the emptiness that lay behind his insistence and to the terrible dilemma he faced of wanting contact but not being able to use it when he got it. He kept trying to reach in and grab from me again what was so elusive for him. As I withstood his seductions I felt cruel and callous. But I felt I had to make that emptiness apparent between us before anything fundamental could change for him. If I softened it or covered it up, the chance for him to confront his bad feelings would be lost and we would be back in his repetitive cycle of search and destroy. As I refused his entreaties and insisted that we talk about the emptiness or try not talking at all, I felt myself to be withholding.

I could see that he was in a great deal of pain and that it was unbearable for him. Although my compassion was aroused, I felt quite distant from him. I got a picture of him in terrible isolation, longing to be touched but locked away. He reported several dreams that echoed this theme. He was in a bank vault behind double steel doors; he was in Lapland outside the igloos; he was on the Russian steppes during the Second World War, searching for his father.

For all the care his mother had provided, I was forming a picture of her withdrawal from him, perhaps when his father had returned from Europe. Then, I guessed, Adam had turned to his father only to lose both parents shortly afterward. We knew his mother had been distraught when her husband left but now I wondered whether she had not become so deeply depressed that she had plundered Adam and his childhood buoyancy as a way to keep going herself. As I suggested these possibilities, they seemed to reach him.

He described himself falling into a black hole that would engulf him. There was nothing there and yet he was taken over. This metaphor from physics interested me because black holes suck everything into them. Black holes emit no light, they absorb everything. Black holes produce nothing. My experience of Adam's attempt to colonize me rang true to his metaphor. He took, gutted and overwhelmed what was in his emotional field but nothing filled him up. At the emotional core of his experience he was desolate, devoid of meaning, frightened and anxious.

Encountering such feelings of disintegration caused Adam to shake involuntarily. The coming too soon, the shaking and the overwhelming feelings of emptiness were the psychological equivalents of a tumbling tower. There was psychic debris all over the place, large pieces of rubble — some reusable, some extraneous, and lots of dust to clear. We did not know what we would find. No wonder Adam repetitively sought a new romance every time he even sensed this place inside himself. No wonder he was so quick to pry open the private places in another. No wonder he was so anxious to create a beautiful aesthetic in his restaurant and cooking. He was desperate to feed, to connect, to find a home away from his inner wasteland.

With this desolation laid bare before us, it was inevitable that Adam would feel driven to flirt with me more. He wanted relief and before something new could develop, Adam would try to pop out of his depression by reverting to his habitual ways of relating. But these attempts were getting lamer and were accompanied now by great sadness. We stared into the life he had put together for himself and confronted his feelings of emptiness.

Throughout the summer I was not sure which way things would go. Would Adam have the courage to hang in there, to bear the bleakness? Could he live with the panic of nothingness? Could he tolerate the feelings of isolation long enough, knowing that I was standing by him but without experiencing my presence as an impingement? If he could do that, I knew he would be out of the woods. He would have faced something of what he feared. He could then grow from inside. His lovely attributes and qualities, which up until now were used in ways that ultimately stung others and failed to heal him, might feel generative and productive for him rather than weapons in his armory as he assaulted the world.

As autumn came my respect for Adam grew. He seemed to have understood what was required. He realized that falling for me or anyone else was, for the present, a diversion. He was swapping adventure and anxiety for a long, cold depression. His emptiness was deadening for him. He continued to work but without a woman to woo it felt routine and meaningless. Nothing built into anything. There were no highs, no little hills even, just unbroken pain and fear. Seeing him at work in his kitchen, his friends observed his attention to detail replacing his former exuberance. It was a sad time.

Although he was in terrible pain and very unsure of himself, he seemed to feel my presence and know that he could rely on me. Finally we were relating to each other, not spinning off into some confection. I felt moved by his pain and he could sense it. His depression and emptiness were in front of us rather than obscured. He was alone and frightened but he was not isolated. He had been reached.

For several months Adam continued to feel empty and depressed. He was in a hole but, hard as it was for him, it was the right place. It expressed rather than denied what he had felt for so long. Without his frantic swoops on others to divert himself, he learned to endure his emptiness. As he began to know and accept this state, it was transformed into a stillness which in time would turn into stability and reassurance.

Gradually the authenticity of our connection crystallized into something of use for him. He could absorb my seeing him in his bareness and was touched by my interest and attention to him. Slowly, slowly, connection rather than seduction could occur between us and between him and others. He became thoughtful and reflective. He was having the experience of being with an older woman without having to perform, without having to "give." He began to confront his terror of abandonment, his hatred of women, his need to have power over them and the ways in which he had done so. All these themes came to be played out between us but not as dramatically as the erotic fantasies that had permeated our relationship. I found it easy to accept and explore his hatred toward me, his fear that I could dump him, his desire to have power over me. That was all manageable. The bread and butter of a therapy. It was only around the erotic that I had had to face my own feelings so dramatically and to sort through why his seductiveness was so compelling. Meanwhile sex was still on his mind, as was his draw to women, but it was now beginning to be part of his life rather than what constituted it.

It was not clear sailing. He fretted that he would lose his charm, that the flashy skills he had parlayed around town would desert him. He could not quite see how who he had been and who he was coming to know himself to be could meld into one human being. There was a fault line running through him and he did not know how the two sides would fit together.

To me it seemed much clearer. Adam was developing from the inside out, gathering up some of his old skills on a new foundation. I could see how much agony he was in, how confusing it was for him, how unstable he felt at having jettisoned so much without yet being able to trust that the new would be any good and would, in time, marry up with the aspects of his old self. I enjoyed his mind and the way he was thinking about himself, as it seemed so much more flexible. As he became less focused on charming others and crashing into their lives, he replaced his pursuit of women with a consideration of the variety of his needs and what would actually touch him.

As spring approached again, Adam met Karen, a thirty-four-year-old TV producer. For the first time since I had known him he had chosen a woman who had a measured response to him. Adam was scared not of sex but of his feelings for her. He wanted to nestle right in with her, to walk hand in hand, to stay close by. He was not used to straightforward affection like this; he was accustomed to drama, to seduction, to complication, to transgression. What frightened him now was the innocent and hopeful feel of their relationship.

"Can I trust myself, Doctor? Will I still feel the same way tomorrow? And the day after that?"

His concern about his ability to sustain loving feelings without the intrigue and the seesaw that were his signature was impressive. I felt encouraged. Knowing one's areas of difficulty goes a long way toward being able to renegotiate them.

Karen was a good match for him. She was not as afraid of intimacy as Adam was nor was she unpracticed at the long haul. Her husband, with whom she had had a good relationship, had died two years earlier. She and her six-year-old daughter were plodding along, trying to live between the cracks of their grief, surrounded by a supportive group of friends and family. Adam was a surprise to her. She had not thought that she was available for a new lover and perhaps it was her ability not to need him desperately and yet still be interested that enabled Adam to respond in a way that was fresh. They were caught up with each other excitedly rather than compulsively. He felt no desire to ravish her emotionally but just to lie with her, to talk with her and to play house with her and her daughter. They made love from a place so deep that he had not known it existed. Instead of the psychological and physical gymnastics he had employed before to reach into another, he now found himself effortlessly taken up with Karen. He did not need to fuck her as she had never been fucked before. Such a concept now jarred him. He lay with her, content, safe inside himself, safe with her and safe inside her.

They had a great half year together. Then Karen's daughter Jessie had an accident. It was a normal falling-off-your-bicycle-type of accident, except that Karen was not easily consoled. When Jessie was in the hospital, and during the physiotherapy treatments for her knee that followed, Karen was terribly distraught. She was deeply shaken, facing again the uncertainties of life. First she had lost a husband, now her daughter had hurt her leg. Karen's distress did not let up.

She leaned on Adam, who was at the ready with his heart and his shoulder. But he could not make Karen feel better and I could see how deeply this disturbed him. He had had his own private struggle when Jessie was first hurt and Karen had turned some of her attention away from him and toward Jessie. Despite his deep concern for the two of them, he felt abandoned. When Karen was spending all her time at the hospital, he found himself sauntering out of the kitchen to the bar of his restaurant to chat up some women, turning on his charm like a talent he had not used for a while. He was on automatic pilot seeking an old comfort. But within half an hour he felt wasted. He had been going through the motions of something that no longer landed him where he wanted to be. He discovered it was better to feel the loss of Karen than to create some diversion for himself.

Between two sessions Adam dreamed that Karen was leaving him. In the dream he watched as she went to his restaurant, emptied it of supplies, filched his recipes. He was confused and tormented. Why was she robbing him? It made no sense. The scene cut to her cooking his recipes and feeding an ailing aunt of his who had cancer. His aunt recovered. Karen said she would stay.

The dream startled Adam. This Karen was so out of character with Karen herself that he took his dream as a message from his own hinterland. Why was he viewing her as a marauder, he wondered. Why was she able to stay with him when she had healed his aunt?

The dream helped us understand what we had not emotionally been able to grasp before. We now had confirmation for our hunch that as a boy he had been prematurely turned into a little man, encouraged to make life better for his mother by solving her problems. His energy and exuberance had been hijacked to keep her going but she had not been able to replenish his stocks. In his attempt to find his own way he had become someone who could service and charm. But this self was unstable because it did not have many resources of its own. For refueling he plundered others as his mother had plundered him. He had made himself essential to them so that he was wanted and needed. Faced with being unable to console Karen and feeling abandoned by her, he was thrown. In his dream he had revisited the distress of his childhood and the patterns of relating that had been shaped between him and his mother. But he found that Karen had healing powers, she was not just the women thief who had, for so long, peopled his unconscious.

This realization excited him. He had chosen a woman who really nourished him and whom he would not discard. This knowledge sat alongside his frustration that he could not make things better for Karen. It was humbling and hard for him. He felt uneasy relinquishing the illusion that he could turn things around for her. Not that Karen was expecting him to make it all better. She was level-headed and knew he could not. She was staying with her hurt, asking for no more than his support.

At first he experienced her need for support as a demand and in part it was a demand but not the kind of demand he was used to. Karen needed him to be patient and present while she struggled with the limits of her own protectiveness. She was not as available to him as before. But neither was she on the way out of the relationship. Adam had initially translated this difficult situation into the vernacular he knew for it resonated with his early abandonment by his father and his mother. When he felt dropped, he tried to still his anxiety by pillaging from the women at his bar. But it did not work. It made him feel worse. He moved back into himself and stayed with what he was actually feeling in order to manage the alarm that Karen's turn to her daughter had provoked in him.

His sensitivity to the dream and to the changes within him helped him accomplish the last piece of our work together. He learned to stand by while someone else was in pain, accompanying them through it but not fearing that he was being used. It made it possible for him and Karen to stay connected and close. He felt thwarted at not being able to repair the situation for her but he did not need to flee from her or from himself. He was now living his own emotional life and was quite able to deal with the real problems he encountered.

I returned to chopping the fennel, my mouth curving in a satisfied smile. What a whirlwind our journey had started with! How ephemeral all the erotic fantasizing had become and yet how absolutely crucial it turned out to have been to privately pursue what Adam had stimulated in me. In my engagement with what he, at that time, saw as the best of himself I came to understand the terror and bleakness at the heart of him. It gave me a view into where his difficulties lay.

I felt then, as I had often felt during our work together, that if his therapy had stopped midway, if I had been too frightened of the erotic feelings I was having or if he had walked away feeling misunderstood, that Adam would have been left, like many other men — a few of whom I have known in my practice and more I have heard about through my woman patients — a man bereft of himself. Men whose emptiness leads them to become psychological terrorists, feeding off the love they can produce for the women they romance and then drop. Men who have to play out and endlessly repeat the pursuit and vanquishing of others. Adam was no longer tied to that destiny. In facing the cold chill of his emptiness, he risked something more. His penis had led him away from a life that was no longer working into one that gave him more possibilities.

Copyright © 2000 by Susie Orbach

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Table of Contents

Contents

A Room with a View

The Vampire Casanova

Belle

Footsteps in the Dark

Fat Is a...Issue

Two Parts Innocent, Two Parts Wise

The Impossibility of Sex

And So

Reflections and Questions

Thanks

Notes

Index

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First Chapter

The Vampire Casanova

I felt twitches in my vagina, pleasurable contractions. It was a sunny Sunday morning in spring, two years after I had stopped seeing Adam. I was chopping some fennel when he not so much entered my mind as tapped on my body, as he had so many times during the course of a five-year therapy. Adam was a chef and from time to time when I was preparing food, his presence would insinuate itself and I would be back in the physical ambiance of our therapy time together.

Adam was a fornicator, a lover, a stud; a man whose daily life was shaped by sexual desire and sexual conquest in a spiral of infatuation, seduction and vanquishing. There were never less than one love interest and two or three gorgeous "girls" on the go, not of course counting on the previously conquered, who would return for occasional trysts when they were in town or between boyfriends.

The year before he embarked on therapy the then 36-year-old Adam developed a problem that jeopardized his perception of himself. He had started to ejaculate too soon. Desperate to make the problem go away, he came to therapy. "Too soon for whom?" I asked. "Too soon for me. You know, too soon for me to really give it to her. To fuck her real special. Like no one else. Take her places she's never been."

The imperative of his sexuality and the potency of his penis fascinated me. It was so present and insistent that I felt swept back twenty years to before my generation's encounter with feminism thought it had remade sexual relations both in and out of bed.

What did coming too soon mean to him? That it wasn't complete? That his orgasm was a squib rather than a release and a connection? Was he anxious? Did he have to concentrate too hard on giving to the woman? Was he insecure?

"All of those, sure," he said on his first session. "See, I really love women," he said, slowing down as he realized he was sobbing. "Take Sarah who I was with last week. Now she's something special." He paused another second. "While I was romancing her, I really believed, you know, that I loved her."

Before self-reflection could count, before he could register how hearing himself was a new experience, he pulled himself out of his pain and slowly spoke what would be ours to sort out over the next few years.

"I'm a physically passionate man," he said as he looked into my eyes and mimed Me Tarzan, You Jane. "It's just nature. But something is getting in the way of mine. So, figure it out, Doc. Come on. Without fucking what's the point. Fucking is my life."

The bluntness of his words and the flip between Southern American formality and crudeness jarred with the softness, almost a sweetness, in his persona. I wondered about the clash.

Adam began to tell his story. Although few feelings came through, the preliminary shape he gave his life had a certain coherence to it. He was born on Long Island in the working-class community of Huntington Station shortly before the end of the Second World War. His father and mother had been childhood sweethearts and she had become pregnant before he went off to serve in Europe. The photos Adam had of his father in uniform and the stories his mother told about him portrayed him as an eager, if somewhat naive, young man, ready to serve his country and see a bit of Gay Paree. War was a romantic moment rather than the reality of bombs, scarcity, cold and death. While he was stationed in England, Adam's father got involved with a Yorkshire woman, who also became pregnant. He promised to take her with him to the United States (Adam often wondered if his father had entered into a fraudulent marriage with her). On returning to New York, Adam's father moved in with his mother and him for a year but when it came out that he had fathered another child, there were terrible fights and eventually he left for California. He kept in sporadic touch with Adam for a few years, coming back once for a few months when Adam was six, but his father dropped out of his life after his eighth birthday when he turned from being a heroic husband and father to a maligned bigamist.

Adam grew up very close to his mother. He was her companion, her little man. At twelve he was making decisions for the two of them, carrying the money she earned as a beautician, telling her how much they could spend. They moved around a lot, from New York to Florida and then around the state, either to catch up with some new man she was after or chasing a job opportunity that did not quite pan out. He learned to make friends quickly and to let them go easily. He was distracted from the pain of his dislocations by the abundant dramas his mother wrought in their lives.

At seventeen, after finishing high school in Vero Beach, Florida, Adam went back to New York, tried butchering, his father's trade, then acting and moved on to selling art and doing exquisite dinner-party cooking. He found his way into a glitzy social scene and discovered how sexy he could be to neglected married women. Wonderful at paying them attention, knowing what they longed for and dressed like a man with twenty times his income, Adam became extremely desirable. In 1972 when he was twenty-seven he married Elizabeth, a wealthy divorcée.

Elizabeth misconstrued Adam's pursuit of her as true love (which it was at the time) and she was crushed by his philandering. She divorced him quickly, giving him enough money to start a restaurant. Designed by a friend, hung with paintings on loan from artists he used to represent, and given sufficient publicity as New York's coolest restaurant just at the time when food and eateries became a leisure pursuit of a large segment of New York's middle class, his restaurant soon took off. He became a respected chef and restaurateur. Meanwhile, his mother, who had moved to New York to be nearer to him after a failed love affair, died of cancer at the age of fifty-five.

Before Adam came to see me in 1980 his life was shaped by two preoccupations: being a celebrity chef -- rushing around judging competitions, doing guest-chef stints in other restaurants, creating beautiful tables for photo shoots, writing a cookbook with his assistant -- and having girlfriends, dozens and dozens of them.

His hectic life and pursuit of women worked well enough for him. He felt gratified by the attention he received, pleased to be the consummate lover and part of a glamorous set. There was plenty of excitement. He was always living in a mini-drama, often of his own making, where one or two of the women he was sleeping with would be on the verge of finding out about another. Concealment and the fear of discovery excited him enormously. I thought of the analyst Winnicott's observation: "It is a joy to be hidden but a disaster not to be found" and wondered what it foretold of what needed finding in therapy.

The scrapes Adam got himself into and the tension of his many work commitments helped him feel valued. He was clearly needed by others. If he had not hit this problem of early ejaculation, he never, he assured me, would be seeing me. "Everything was coming up roses till that point. Hell, I wouldn't have been here sitting with you, ma'am. I'd a been making you sweet sweet love." Extreme intensity exuded from him even in this play tease and I could sense how compelling the turn of his attention to a woman might be.

His discomfort in seeking help from a woman after many years of looking after women in one way or another was pronounced. He was awkward as he tried to give a fuller account of himself, to show some vulnerability, not to be the big guy who was always in charge.

Yet he settled well into therapy. He was relieved to be able to talk about his life, the ins and outs of his love affairs and the emotional patterns he wove. As we got to know each other better, more details emerged about sex and loving. He now frequently sought a different kind of sex, a more violent encounter teetering on the edge of bondage and rape. His sexual fantasy life had moved in that direction when he started to come too soon, and he had discovered that while masturbating he could sustain his excitement long enough with a violent fantasy to give him a satisfying orgasm. It did not work when he was actually with someone. With a woman, however much he wanted her, he felt precarious, anxious and that he "came too soon."

Adam was indeed a sensual man. I could feel it in greeting him. When I put out my hand to shake his on our first encounter, the presence of his hand stayed with me. After he left the consulting room, his smell was in my nose. When he stood up to leave it was as though the room were being emptied. When he talked about women, I could feel his love. Clichéd words which I might have tended to laugh at if they had come from a friend took on a lush, rich tone. He found women miraculous, beautiful, sexy, delicious and inviting; their movements, their smells, their pretty lingerie draped nature with tenderness. His open appreciation and joy gave me a new perspective on my gender's sexuality and I could almost see women from his perspective as wondrous, luscious, magical, holding secrets desperately worth penetrating.

He was nothing if he wasn't a lover, he said. He needed to pursue, to please, to have a woman's pleasure in his sexual capacities reflected back to him. He wanted to get to the heart of women, emotionally and sexually, so that they would be forever transformed by his touch. And they were. His intensity, interest and sexual certainty made it possible for his lovers to open up, to feel as though they were discovering their sexuality as adult women and to go where "they'd never been before." But despite his and their evident satisfaction and pleasure, Adam was always on to the next encounter, the next woman who could confirm him, who by opening her legs and her heart would make him feel he existed. Until his sexual problem.

The sexual problem that so dismayed Adam brought to a stop his habitual way of going about life, his way of understanding himself, his way of being with a woman, his way of giving and receiving love and his way of feeling good. All that he knew about himself was now thrown into question. In choosing psychoanalytic therapy, he was embarking on a journey to make some sense of the way he organized his emotional and sexual life, to question what motivated him, to fathom why his penis was forsaking him, to connect up, as he might say, with his emotional heartbeat.

While Adam was desperate to get his penis working for him again and had consulted physicians about techniques to forestall orgasm, he found that he was curiously relieved when I suggested that his "coming too soon" might hold clues about aspects of himself that as yet he did not recognize.


The issue of symptom relief has always been a thorny one for psychoanalysis. In Freud's work it was the symptom, principally the hysterical, non-organic symptom that disabled the individual in many different ways that psychoanalysis at first sought to comprehend. Anna O's tortured limbs, Cäcilie M's paralysis and the widespread phenomenon of physical anesthesia were the material that Freud and Breuer drew on in 1895 in their groundbreaking Studies on Hysteria. Since that time psychoanalysis has swung between treating symptoms and interpreting them as metaphors, regarding them as manifestations of unconscious processes. Sometimes psychoanalytic patients have been relieved that in the analytic space they can speak of whatever enters their minds, that they need not slot everything about their experience into the narrow confines of their symptom. Sometimes they have been alarmed because their symptom, despite a most thorough analysis, remains entrenched. Clinicians walk an uneasy line between addressing the symptom per se, giving the person space to talk about it and how the symptom expresses, disables, enables and enunciates aspects of the individual, and at the same time offering the possibility that there are other ways of experiencing that the patient may not be allowing herself to acknowledge.


Adam was quite interested to know what stories he had invented for himself about his magical phallus and why, if it was so magical, these powers had now deserted him. He could see at once that his self-conception as a lover was a lens through which all his experience passed and although part of him longed to be free of sexual anxiety and to return to the status quo, he was intrigued by the notion that there was something to know beyond his symptom and perhaps beyond his sexuality too.

It was not long into the therapy before Adam registered that I was a woman. Since his only repertoire with women was either to look after them or make love to them, seeing me as a woman put him in a quandary. Interested as he was that I be the doctor in a metaphorical white coat who would help him examine his life, he could not keep me in that category. He had to flirt.

It would be inaccurate to say that he would flirt when he was anxious or to fill the space or, as happens in normal social life, as a way of smoothing over those awkward moments that can occur between women and men. No. Such a description would strip Adam of his essence. Adam was flirtation incarnate. He could not help but flirt. When we first met, this flirtation had been expressed as charm. As his therapy continued, however, he beamed his seductiveness toward me and the analysis of it, including his active sexual pursuit of me, became a central feature of our sessions.

For a few months Adam and I explored the life of his penis. Through this valued part of himself he felt able to give and receive love, to make women desire and need him. His penis, he felt, let him convey to a woman that he was interested in her emotionally and sexually as she had never been noticed before. The intensity of his appeal, the promise he held out that he would reach and move her, spiritually and sexually, became irresistible. A woman who gave a hint of returning his interest would receive an emotional assault that not only had her longing for him but left her feeling that without his attention she was somehow lost.

As I listened to his accounts of seductions I felt acute sorrow for Adam in his fierce search to connect. I felt scared too for the woman he was currently after. I would not have wanted to be in her position. I could sense that he picked his women up in one place, twirled them around and then pulled them inside out, so that when they were dropped they had been through a sexual and emotional revolution that left them reeling as they tried to pick up the pieces of their pre-Adam selves. Although he played it as a game -- game, set, match -- it was the women who would be knocked out by him. He could always go on to the next conquest, the next woman who showed him how much she desired him.

In pursuit of a woman Adam was alive. Although he was aware that his encounters had a predictable pattern of pursuit, seduction and loss of interest, the chase worked for him. Adam's well-being, his sense of self, his raison d'être required a sexual quest, the challenge of teasing and coaxing the heart of a woman to open up so that he could capture her. When he secured the woman he was desperate for, there was a moment -- sometimes a longish moment before his interest dissolved -- when Adam felt loved and accepted.

He knew that he was sexually appealing. His distress over coming too soon humiliated him. It humiliated him that he had had to come to see me. By flirting in therapy he was bringing forward what he felt to be the best of him, inviting me to be entranced by those aspects of himself that he esteemed, so that as we entered into the not-so-nice bits, he was reassured that I could see his charm and accept him.

At first his flirting tickled me, somewhat as a teacher might feel at the predictable unfolding and development of a student she enjoyed. I had been flirted with in the consulting room before. I could anticipate that something of Adam's flirtatiousness would enter our relationship and, remembering Freud's injunction to analyze rather than take personally the professed love of a patient, I was not much worried about this entry of the erotic into the therapeutic space. It was not that Freud thought that the entreaties of a patient were disingenuous or unworthy but that we could learn much more about the patient through applying ourself to understanding the entreaties. Freud's caution to the analyst was that such seductions were an undeserving love, a transferred or transference love (from a parent to the analyst). Such love clothed that which must be uncovered if psychoanalysis was to be of value. The analyst need not be flattered by, or taken in by the sexual displays and exhortations of love emanating from his female patients. "He has no grounds for being proud of such a 'conquest,'" Freud warned.

So I was not surprised when Adam came on strong. He had been able to tell me that without the pursuit of a woman, he felt cavernously empty, as though he did not exist. I could imagine that at some point in our sessions I might briefly become the object of his desire. That, when or should this occur, I would be pointing out to him how his flirtation or desire could steer us in the direction of understanding what it concealed. I was surprised though by how strong and how explicit his appeal to me was.

"I have to make love to you," he said. "I need you more than I need therapy. It's killing me coming here session after session dreaming about you, thinking about you, smelling you -- your sweet body smell and your perfume." He was really revving up now. "I imagine caressing you. My hands between your silky legs, my body aching, desperate to be with you. I know you feel it. I know you want me. I know you're just holding back because you're my doctor. I know you are."

No, Adam, that's not quite right is what I was thinking, but as he was declaring his desire and I was formulating my response I could feel my body tingle, Freud's injunction notwithstanding.

"You don't believe I'm for real because I told you about all those other girls. But this is different. You know it. You can feel it. I know you can. We'd both be missing something we've never had before if we said no to it. This is big. Something that comes round once."

I said nothing. I thought about Adam and his mother and how confusing it might have been for him to be her little man. I thought about how hard the renunciation of his childhood sexual desire for her might have been for him when she treated him so much as her partner rather than as her son. The togetherness he craved, the being reached and reaching out that were his refrain with women, could have been too tantalizingly for him. I wondered about her seductiveness, how much sexual play had passed from mother to son to bridge the gaps she felt in her sexual and emotional life.

My thoughts were intended as much to calm me down as they were to analyze the situation. This was not a little flirting around the edges but Adam's powerful declaration of desire. I was being given the treatment.

The problem for me was that I was not unmoved. I found Adam's entreaties attractive. I talked to myself in an attempt to slow down the emotional steamroller coming at me.

"I've never opened up like this," he continued in an approach modified to turn on a psychotherapist. "I've never been touched like this. No one has ever let me find myself before."

"Perhaps you're feeling some relief, sensing that it is possible to be understood more fully instead of having to rush in and out of relationships looking for some brief magical contact," I said, hoping that a bland comment could slow time and defuse the erotic.

Adam steamrollered on. "I know you think this is me doing my number but you've got to believe me. I've never bared myself before anyone else. All my honesty before was bullshit. My nakedness was a sham." I could feel him shifting into his Southern gentleman mode as he continued. "I thought I was bringing myself to the other person but it was a pretense. Listen to me, will you. Don't analyze this all away. I'm serious. Really serious. I want to, I have to, make love to you."

As Adam beamed his interest at me beyond the come-on line, his insistence, his passion, his desire was palpable. I was his prey. I could almost watch it happening in front of me except that I was part of who it was happening to. I could tell I was going to have a hard time with it. If I did not take it seriously, the therapy would be ruined but if I took it too seriously, the therapy would also be ruined. I was going to have to find the line to walk. Was I in danger, like his other women, of being tossed up, twirled around and then spat out?

I could sense him getting under my skin. I tried to analyze what was going on, to understand and to calm myself. This is nothing different in kind, I reminded myself, from the emotional places I have been to with other patients. It is different in quality because this is about sex and the erotic. I am feeling scared but if I do not get to what this is for him, if I do not take my experience as a sounding-board -- a version of what he is feeling, needing or has felt -- then as a therapist I am letting him down.

I said this to myself, hoping that by formulating it this way I would be able to keep my vision clear. I would be able to feel his attractiveness, what drove him and pulled women to him in a way that was useful to him. If I was not to believe this would happen in the course of my becoming awash in the effects of his seductiveness, then I would have had to stop being his therapist. And although I considered that option, it was too naive and clinically irresponsible. Adam was doing what he needed to be doing, what he could not help but do. If he could not act in his therapy the way he did in the world and so have this behavior understood, there was little hope that what troubled him could be grappled with.

The genuineness of his appeal landed on me much as it had landed on the dozens -- no, the hundreds -- of women he had bewitched before. While most of my channels were caught up in his appeals, an observing channel remained open. As I felt drawn by his allure, I was fascinated by how incredibly sincere and authentic it felt. It was as though his whole being exuded something utterly appealing. I saw and felt that I wanted to love him. The divide between the thought and what might happen felt precarious. He pulled on me in some irresistible way. The opportunist Casanova I had imagined him to be when he had talked earlier about his capacities as a romancer was effaced. Instead there sat before me a beguiling mixture of an eager virgin heart and a self-confident lover. So this is what hooks his women, I thought, even as I felt more than flattered and pleased by his attention.

I went to bed that night full of Adam. He stayed with me through the night so that when I awoke I was not sure whose bed I was in or who was in mine. My senses were sharpened as they can be in the throes of an infatuation. As I went about the pedestrian tasks of putting fresh flowers in the consulting room, reading the morning's mail and processing the news, I thought how wondrous life can be. When a friend phoned about some plans for the evening and heard an unfamiliar lilt in my eight A.M. voice her inquiry about my good mood made me try to get a hold of myself. Just where was this singing inside me coming from? Was I letting the countertransference -- the feelings the therapist has for the patient -- get a bit heady? I chuckled to myself. I was not prepared to give up the good feelings so hurriedly. So much of the psychotherapist's day is spent entering painful places, processing anxiety, buffeting the sorrow, anger, confusion and terror that patients bring. I went into the shower and as I let the water run on my body, I felt with pleasure its silkiness, the sensual flow of the water's pulse from the showerhead on to my body.

All at once the image of an enormous showerhead in a hotel bathroom I had glimpsed years before melded into a picture of Adam and me making love. He was trying to touch an erotic part of me that had never been awakened. I found myself smiling, even blushing, as I realized how exquisite, but also how ridiculous, it felt. I was in a state of sexual reverie, no doubt about that. Could I trust it to stay there? Every therapy is an adventure, I told myself. Unpacking it was part of the job, feeling it enough to know what was going on.


Ten percent of patients are vulnerable to sexual advances from their therapists. It is not only therapists leaping onto their patients that creates such a worrying picture, but also the danger that Freud highlighted of how an erotic transference encourages a therapist to act on rather than to analyze erotic feelings which can lead to an abuse of the therapeutic situation. To protect patients, therapists until recently felt it best to deny or sidestep their arousal but, if it continued, to rush back into therapy themselves and to case supervision to sort themselves out and to untangle the particulars of a case in which they felt the threat of becoming unprofessionally ensnared.

This undoubtedly helpful protocol is mandatory for a therapist for whom sexual arousal during the course of a therapy is not a single experience but a habitual trouble. However, alongside this minimum protection for the patient, a body of thought has begun to emerge over the last decade suggesting that a therapist who finds herself aroused might best help her patient if she can become less afraid of her responses and keep herself consciously aware of them long enough to think about them privately. Indeed Michael Tansey suggests that it is precisely analysts' fear of their own sexual feelings toward their patients that needs to be addressed so that the erotic transference can be explored. If analysts cannot countenance such feelings within themselves but suppress or deny them or separate them from conscious awareness, there is a much higher chance of inappropriate sexuality being unwittingly enacted in the therapy. This danger is decreased if the analyst can think about erotic feelings for a patient (and what they signify) without fear of censure.


Although part of me envisioned professional reproof for the thoughts I was having, another part of me knew that I had to go on with this exploration and receive the feelings I was having as part of the treatment. Bodily sensations were as valid and useful as any others. It was just a question of holding on long enough and being alert enough to the idiosyncrasies of this arousal to untangle the bits that belonged to me personally from those that emanated from or were created between Adam and myself. The important thing, I told myself as I stepped out of the shower, was to be aware of any desire on my part to exploit the situation for my own sexual ends. Was being wanted in this way a buzz to a woman in a long-term relationship, used to great intensity but removed from the insistence of early sexual passion? If this was the case, and I knew I would have to question myself hard and honestly here, was I unconsciously encouraging a flirtation with Adam? Did I need him to confirm some aspect of my desirability?

Ugh. I did not much like that thought. If it was accurate I would have to take special care of what message I was sending Adam. Did I have a wish to be found desirable? Was this the chink of receptivity he had referred to in seeking women? I was not seeing Adam today. I had time to reflect on myself later. For now I focused on what I thought Adam was up to.

In one way Adam was taking up residence inside me in the manner he did with others. I accepted that this was his way of being attached. I recognized that in privately surrendering to his flirting I was wrapping myself up in his idiom. It was a way of speaking his language, of becoming close in the way that he could. That might be how he would be imprinted on me for now, just as other patients with a different psychic grammar would become emotionally imprinted in their unique ways. As I realized this I let his flirting stay with me. If this was the way he was finding a psychic home with me, so be it.

I went about my sessions that day grateful for the ones in which the engagement was more straightforward. That night I went through a list of the unexpected emotional journeys that I had been swept up in during years of being a therapist, journeys choked with difficult, powerful, unpleasant feelings.

I recalled the times when I felt hated. Unable to provide what a patient felt she needed from me, and unable to repair the horror of her past, I felt her hatred of her parent blending with her hatred of me and I became a useless, contemptible punching bag. The discomfort of that had been as hard to bear as the occasions when I felt dropped, jerked around or intensely needed.

I also remembered times when I felt clinically lost, when my brain scrambled, when I tumbled into another's psychic world not sure that I would find myself and my psychic footing again and having little to hold on to except a certain knowledge of the inevitability and the necessity of it all. I reminded myself that the therapist's lot is to be both in the place that is demanded by the patient while being able to recover oneself. I knew I needed to be affected, to be disturbed, to experience something of the patient's psychological state. I had always recovered myself and I had learned that it was an easier ride if I allowed myself to register rather than resist the pressure exerted on me in the therapy relationship. That way I was responding to only one emotional assault at a time. To have interfered by resisting would have doubled my confusion.

At least, I consoled myself, I had an inkling of what this emotional journey might entail. Adam had been so forthcoming about what he did with women, I had such a graphic picture of the way he picked them up and spewed them out, that I was well forewarned. If I were to surrender to his exhortation, not literally but inside myself, then I had a fair idea of the territory. It was not going to be a mystery.

The session following the weekend, Adam started right in. He had spent the weekend making love to Laura while thinking about me. Some love, I was thinking mockingly, rebuked by my own conceit. But before I could let myself off the hook, Adam's seduction took on a particular twist.

"The thing is this, Doc -- and I know you can't believe that I'm getting into someone else's panties if I love you so much -- the thing is, listen, please listen, 'cause this is weird. I could come right and I could be with this woman long enough because, because of what's happening between us."

In case I was slow to catch on, he repeated himself, refining it as he did so.

"Listen, I'm saying something about how you've helped me. Sex was what it was meant to be. The only thing was I wasn't making love to Laura. I was making love with you."

My mind rushed to interpret. Well, of course, that made a certain sense. Since he had lost his mother, his love felt unsafe. He might be engulfed by another woman. His attachment to his mother with its sexual taboo kept him relatively protected. He could love his mother and be sexual with other women. While it was not wholly satisfactory, at least he was not overwhelmed. He did not have to deal with his erotic feelings toward his mother (or hers to him). He could stay emotionally loyal to her, not desert her by ever really loving someone else. But when she died, this compromise had collapsed. He had had to sever the erotic lest he become smothered. Now I was a stand-in for his mother. His attachment to me mimicked aspects of his feelings for her, except that with me he could get a step closer to exploring the sexual.

I told Adam what I thought might be going on. I was not sure if I had a hold of something central for him or whether I was simply relieved at the clarity (however temporary) this brought me. At least my sexual feelings had evaporated and I was back on my feet.

Adam rejected my thoughts. Or rather he took them as a rebuff and, starting up his sexual motor, I got the full works once again.

"Hey, Doc, watch out! Don't hide behind the Freud stuff. I was trying to tell you that you're really helping me. Our love is making me better. Hey," he added, flipping to a direct physical approach. "Cute boots. You're looking great today."

I felt weary at the thought of the attempts I would be making over the rest of the fifty minutes to see what was under, inside and wrapped around this sexual bid for me and his focus on what might matter to or move a woman.

"Your attention to me, how I look, what I am wearing and how quasi-helpful I'm being, has a real intensity to it. It's as though you scan to get what will touch me and then pull me close to you."

"Yeah, Doc. Sure I do. That's what love means. You got a problem with that? You're one beautiful lady and I want you."

There was something about his Southern way of speaking that turned me right off. I was grateful for that and went back to the slog of trying to talk about his weekend with Laura and his feelings of attachment to me. I was not altogether successful because as long as I refused to speak through his metaphor, the distance between us grew. And while Adam would in time need to experience that space between us, I sensed that as yet he could not bear it. He could not approach the void. It was too difficult. He'd rather go for a tussle with me and continue to try to make the conversation sexual. To bring back the tease. To make our contact sing for him in that way.

He yanked one way and I yanked the other. Several sessions proceeded in this manner. He would make a flattering comment about my appearance or the way I said things. I would try to get behind or beyond those words to what else he might be saying. Enraged that I was not taking what he said at face value, he continued to beseech me, to tell me that the only reason he was coming to sessions was to court me and then we would fall into silence.

For ten months the therapy was on the edge. It teetered between his insistent, attempted seductions of me and my equally insistent position that we had to understand why he was so caught up with me, what he would be feeling if he were not, what we might be able to address in therapy if he could be with me without having to sexualize our encounter.

By challenging the sexual nature of his interest and attachment to me, I was denying the essence of him, he felt. While he battled to seduce me, I battled to make him face his emptiness. I felt cruel, almost callous, in my pursuit of what I felt he needed to do clinically.

Of course I discussed endlessly why Adam now found himself so caught up with me. Of course I tried to see what this "falling for me" was a panicky reaction to. Of course I repeatedly analyzed and suggested what I thought might be going on.

A lot of the time I stayed quiet. I needed to reflect on what he was saying, what I felt I was trying to say to him, and what I was feeling. My working hunch was that he was scared of contact with a woman that wasn't sexualized, that it made him too vulnerable, put him in touch with feelings of dependency, of rage and engulfment which lay at the core of the difficulty he had brought to therapy. I did not want to desexualize and reduce what he was expressing to infantile longings, but I felt strongly that if he could only get to those feelings, rather than divert himself with erotic play, we could address the difficulties he had faced growing up and transform the legacy they had left him -- a legacy in which he was unable to own up to his rage and hatred of women, his fear of being dependent on them and his fear of being taken over by them.

I had an outline of how I thought the therapy might proceed if I could only get it on track. I juggled where I thought the treatment needed to go with my attempt to be open to where it was going. Resisting his insistence that we play in the erotic had merit, I felt, but I noticed that even our tug of war about where the work was to go had started to take on an erotic aspect too. In my rejection of his sexuality I feared I was dangerously close to the edge of sadism. Mindful of his recent interest in sadomasochistic sex, I wondered whether whatever I offered would be retranslated into the sexualized language he felt safe in.

The therapy continued in this manner. I wanted to find a way to extend his emotional repertoire so that other forms of contact could touch him. I made silent interpretations of his behavior. If I thought they would be useful I articulated them. Much of the time I was quietly trying to be with him, not be rattled by his sexual come-on and not reject him. I was caught in a bind for the way I could stay with him through the sexual onslaught was to do the very thing that infuriated him -- transposing his sexual idiom into one I could work with. I hoped that by showing him it was possible to survive the anxiety I believe his sexuality covered up, he might find some confidence to approach it. I felt rather like a tired old schoolteacher insisting that the unruly children stay in their seats instead of running around the classroom. I was doggedly maintaining a boundary that was not to be crossed. But just as it would be for the pupils, what I held out for him was of doubtful pleasure or benefit. Running around was so much more fun.

The killjoy in me made me question myself further. Was I just a dreary middle-aged woman who would not play? Was I excessively rigid? Was I like those withholding therapists who refuse to enter into their patient's world and so leave the person stranded while they complacently rely on theory to keep them going? Maybe Adam was right. Life was dead boring without passion and crises de coeur. I had enjoyed the frisson between us just a few months back. Why was I pushing the richness of ordinary relating when it was manifestly so thin in comparison? Was I settling for emotional steadiness and some theory about how to live rather than embracing life?

I thought back to when I was younger, when my life had been much more on the edge, when I had been on the lookout for emotional adventure and was game for so many risks. Was I really sure I preferred my existence now or was I just rationalizing its staidness? Had I, without noticing the downside, dried up, deadened myself into defensively using my understanding of psychological processes to pin me down and keep me in one place? Did I look ruefully at women my age who were still adventurers before quickly comforting myself with a dose of smug maturity?

I did not really like this confrontation with myself. I felt I was sorted at a fundamental level. I did not want to be disturbed in this way by Adam. I did not like the challenge he was setting me. I knew the challenge was as much about him as it was about me. I knew that he needed to come up against me and find me steadfast. But I also knew that for me to be authentically firm, for me to genuinely get to what was behind his sexualization of our relationship, I had to experience and explore what he was throwing at me, not only his seductions but what his erotic play for me and my response to it said about my life.

One weekend I fell ill and went to bed with a fever in the afternoon. My family, taking care not to disturb me, left the house. In the unusual stillness I found myself fantasizing a different life, a life in which neither my family nor my work kept me tied down, a life that held a spontaneity different from the one I had become accustomed to. I found myself thinking about Adam and the hotel shower once again. I imagined telling my family I would be away the following weekend and then going to spend it with him.

The thoughts frightened me and, combined with my fever, made me not quite sure what was happening. I called a trusted friend and colleague to talk it over. A bit of supervision was what was required. Was this fantasy any different, I questioned myself, from the imaginings I had about another patient -- to wrap her in a blanket and take her home? Was I insisting that Adam's erotic play was distracting us from more substantial issues because I was scared of being entangled?

I reminded myself yet again that a surrender to the psychological magnetism of a patient paradoxically strengthens the pull to recover oneself. I knew from experience that the less I opposed what might happen inside me, the speedier I would "refind" myself and be able to give back to Adam something useful that arose out of my emotional "surrender." I reassured myself that even as I slid along with Adam's seduction and became caught up in it, there would be a sliver of an observing eye looking and thinking about the experience I was having in a way that would be fruitful to him.

The next Monday there was a change in the session. Adam was not much interested in me. He was polite and solicitous but his energy was not relentlessly engaged in making me feel I was the only person who existed for him at that moment. Although I was extremely interested in the change in him, I was also disconcerted, since after the ten-month barrage I had finally allowed him to seep into me in the way he said he wanted to. Was there a concordance here between my taking him in sexually in my mind and his no longer needing me? Was this exactly what always happened with his lovers? He would lose interest when he had fully captured theirs. Once a woman really wanted him, his desire for her waned. It was the play that got him going, the conquest. A woman's surrender was her death knell. She would want him but he would no longer be interested in her.

The observing part of me smiled. It is often the case that when a therapist makes a shift inside herself because she has understood something about her feelings in relation to a patient, or allowed for some possibility, that wordlessly, almost miraculously, the atmosphere changes. The part of me that had been caught up but had then finally let myself to go the hotel to have the affair let Adam off the hook. Once assured he was wanted, he could move on. By my wanting him, he had something of me inside him. He was not as empty and his desperation was stilled. For the present. Now the therapy could move forward. There was new information, new data to consider. The essential piece of him needing to be wanted, of having physically to conquer me, had now happened between us. What I was feeling might be a crucial insight into Adam's inner world, a part of himself that was either hidden under the pursuit or split off and projected onto his victim.

As Adam withdrew his interest from me, I was relieved to see that the sexual buzzing he had stimulated in me stopped. There was a slight sense of loss. I felt a little wan but my dominant feeling was one of relief. I felt eager for the new gear I hoped the therapy and our relationship might shift into.

But I was too quick to feel this was a breakthrough. Over the next few sessions as the sexual agenda expired in me, it got restimulated in him. I wondered whether I was going to be trapped in some paradoxical play in which if he did not come on to me sexually, I would have to be privately drawn to him. I was exasperated. Now he was flirting not only in every session but for almost all of the session. I could not quite place how I felt. There was something peculiar about being paid to receive sexual flattery for fifty minutes several times a week. There was also something harassing about it. More annoying was the fact that over the next few weeks Adam's sexuality found its way back to disturbing me and I found myself fantasizing once again.

Having been there once before, I wondered whether there would be a replay of what had occurred weeks earlier. Would it be that as soon as I took his sexual bid for me seriously, it would evaporate for him? Would I repeat the experience of both letdown and relief? Would Adam once more, after a few more sessions of sensing my withdrawal, come on again? I wondered how many rounds we might have to go like this, punching and blocking.

As I allowed myself to consider Adam as a lover, I felt his force, his strength and his desperateness. As I entered the fantasy, I dimly felt that I was not being invited to have a relationship with him, to create something with him. Sure, I was going to be given lots of attention but there was a deeper feeling: I was being asked to receive his intense hunger and desperation, to open myself up to be used by him. I shuddered. It was what I had formulated for myself theoretically but until this moment I had not really known or felt it. I had a glimpse of the way he picked up, hollowed out and rattled his women while staying slightly at a distance. Although he appeared present, sexually attentive and desperately wanting, a chilling absence stood where relating might have been expected. I wondered if this is what he had always felt with his mother. I wondered whether he had felt used, toyed with, rather than related to.

And yet while I could analyze the way he seemed to bore into me and even feel how disagreeable it was, it was not the only feeling. I was also drawn in, fascinated. Out of the desolation that I felt in surrendering to the fantasy, I felt the coldness at the heart of his seduction. My desire to reach him emotionally and transform what seemed like a steel rod at his core was aroused.

By now it was spring and Adam went away to judge food competitions in France for two weeks. During that time I kept a warm feeling for him and I missed him. Before he left I had felt something of the terror and isolation of his disturbance which would enable the work to proceed. I was looking forward to his return.

When he came back, he was incredibly offhand. Predictably, his interest in me was extinguished. Not only had I been aroused -- which perhaps he had subliminally picked up -- so he was not compelled to chase me, but more significant perhaps was how he dealt with his attachment to me in his absence. Without me there to represent it and literally embody it, our relationship was of no value to him. It was because he found his needs so overwhelming and so hard to tolerate that he had to be on the lookout to have them related to every second. Since he could not trust our attachment (or any other), he would transfer his hungers elsewhere to where he might get the sense that he was not flayed by them but was instead having them responded to. I was sure, and he confirmed it, that he had had umpteen liaisons while he was away.

My curiosity and my feelings about these other liaisons did not surprise me theoretically. But emotionally I felt betrayed. While I had been hanging on to our attachment enough to taste how abject his inner experience was, how desperately needy he was, how the steel core at the center of him made him unable to really love or use the love that came to him, and how much I hoped that our sessions could hold on to this truth, he had disappeared.

It was as though I had been scooped out and vampirized. My insides had been all stirred up with no place to go. I recognized myself in the description of my patients who had been at the receiving end of Adam. Now I too felt that I was in need of something from Adam that I had not needed before, something he had tantalizingly promised would be met and which he was now withdrawing. I felt sick, foolish, ridiculed.

Fortunately I had the framework of therapy to steady myself. I set my energies to thinking about what I had experienced. I had an image of him climbing into me, creating a cavity through the center of me and then banging his fists on my skeleton from the inside. I felt colonized and as though he were eating me up. In the sessions his flirting, with its charm and sweetness, had been predominant. Now I felt him swooping in on me like a vulture.

I felt sick inside but also clearer about the work. I needed to find a way to bring out some of the feelings I had experienced with him to see whether they were a version of the horror he was always trying to escape from. My hunch had been that a dreadful emptiness sat inside him. What I was not clear on was where the vampirizing came from. He was so practiced in this behavior, so intent on sucking something out of the women he landed on and in, that I felt he might be trying to solve something that had happened repetitively to him early on, so that it had become the salient emotional experience for him. I conjectured that in his actions he was trying to gain a kind of mastery over the experience of having been swooped on by now becoming the agent rather than the victim of the swoop.

As my understanding stopped my sexual desire, Adam's flirting started up again. But with a distaste for what had happened last time, I was not to be rattled. I directed the conversation to the emptiness that lay behind his insistence and to the terrible dilemma he faced of wanting contact but not being able to use it when he got it. He kept trying to reach in and grab from me again what was so elusive for him. As I withstood his seductions I felt cruel and callous. But I felt I had to make that emptiness apparent between us before anything fundamental could change for him. If I softened it or covered it up, the chance for him to confront his bad feelings would be lost and we would be back in his repetitive cycle of search and destroy. As I refused his entreaties and insisted that we talk about the emptiness or try not talking at all, I felt myself to be withholding.

I could see that he was in a great deal of pain and that it was unbearable for him. Although my compassion was aroused, I felt quite distant from him. I got a picture of him in terrible isolation, longing to be touched but locked away. He reported several dreams that echoed this theme. He was in a bank vault behind double steel doors; he was in Lapland outside the igloos; he was on the Russian steppes during the Second World War, searching for his father.

For all the care his mother had provided, I was forming a picture of her withdrawal from him, perhaps when his father had returned from Europe. Then, I guessed, Adam had turned to his father only to lose both parents shortly afterward. We knew his mother had been distraught when her husband left but now I wondered whether she had not become so deeply depressed that she had plundered Adam and his childhood buoyancy as a way to keep going herself. As I suggested these possibilities, they seemed to reach him.

He described himself falling into a black hole that would engulf him. There was nothing there and yet he was taken over. This metaphor from physics interested me because black holes suck everything into them. Black holes emit no light, they absorb everything. Black holes produce nothing. My experience of Adam's attempt to colonize me rang true to his metaphor. He took, gutted and overwhelmed what was in his emotional field but nothing filled him up. At the emotional core of his experience he was desolate, devoid of meaning, frightened and anxious.

Encountering such feelings of disintegration caused Adam to shake involuntarily. The coming too soon, the shaking and the overwhelming feelings of emptiness were the psychological equivalents of a tumbling tower. There was psychic debris all over the place, large pieces of rubble -- some reusable, some extraneous, and lots of dust to clear. We did not know what we would find. No wonder Adam repetitively sought a new romance every time he even sensed this place inside himself. No wonder he was so quick to pry open the private places in another. No wonder he was so anxious to create a beautiful aesthetic in his restaurant and cooking. He was desperate to feed, to connect, to find a home away from his inner wasteland.

With this desolation laid bare before us, it was inevitable that Adam would feel driven to flirt with me more. He wanted relief and before something new could develop, Adam would try to pop out of his depression by reverting to his habitual ways of relating. But these attempts were getting lamer and were accompanied now by great sadness. We stared into the life he had put together for himself and confronted his feelings of emptiness.

Throughout the summer I was not sure which way things would go. Would Adam have the courage to hang in there, to bear the bleakness? Could he live with the panic of nothingness? Could he tolerate the feelings of isolation long enough, knowing that I was standing by him but without experiencing my presence as an impingement? If he could do that, I knew he would be out of the woods. He would have faced something of what he feared. He could then grow from inside. His lovely attributes and qualities, which up until now were used in ways that ultimately stung others and failed to heal him, might feel generative and productive for him rather than weapons in his armory as he assaulted the world.

As autumn came my respect for Adam grew. He seemed to have understood what was required. He realized that falling for me or anyone else was, for the present, a diversion. He was swapping adventure and anxiety for a long, cold depression. His emptiness was deadening for him. He continued to work but without a woman to woo it felt routine and meaningless. Nothing built into anything. There were no highs, no little hills even, just unbroken pain and fear. Seeing him at work in his kitchen, his friends observed his attention to detail replacing his former exuberance. It was a sad time.

Although he was in terrible pain and very unsure of himself, he seemed to feel my presence and know that he could rely on me. Finally we were relating to each other, not spinning off into some confection. I felt moved by his pain and he could sense it. His depression and emptiness were in front of us rather than obscured. He was alone and frightened but he was not isolated. He had been reached.

For several months Adam continued to feel empty and depressed. He was in a hole but, hard as it was for him, it was the right place. It expressed rather than denied what he had felt for so long. Without his frantic swoops on others to divert himself, he learned to endure his emptiness. As he began to know and accept this state, it was transformed into a stillness which in time would turn into stability and reassurance.

Gradually the authenticity of our connection crystallized into something of use for him. He could absorb my seeing him in his bareness and was touched by my interest and attention to him. Slowly, slowly, connection rather than seduction could occur between us and between him and others. He became thoughtful and reflective. He was having the experience of being with an older woman without having to perform, without having to "give." He began to confront his terror of abandonment, his hatred of women, his need to have power over them and the ways in which he had done so. All these themes came to be played out between us but not as dramatically as the erotic fantasies that had permeated our relationship. I found it easy to accept and explore his hatred toward me, his fear that I could dump him, his desire to have power over me. That was all manageable. The bread and butter of a therapy. It was only around the erotic that I had had to face my own feelings so dramatically and to sort through why his seductiveness was so compelling. Meanwhile sex was still on his mind, as was his draw to women, but it was now beginning to be part of his life rather than what constituted it.

It was not clear sailing. He fretted that he would lose his charm, that the flashy skills he had parlayed around town would desert him. He could not quite see how who he had been and who he was coming to know himself to be could meld into one human being. There was a fault line running through him and he did not know how the two sides would fit together.

To me it seemed much clearer. Adam was developing from the inside out, gathering up some of his old skills on a new foundation. I could see how much agony he was in, how confusing it was for him, how unstable he felt at having jettisoned so much without yet being able to trust that the new would be any good and would, in time, marry up with the aspects of his old self. I enjoyed his mind and the way he was thinking about himself, as it seemed so much more flexible. As he became less focused on charming others and crashing into their lives, he replaced his pursuit of women with a consideration of the variety of his needs and what would actually touch him.

As spring approached again, Adam met Karen, a thirty-four-year-old TV producer. For the first time since I had known him he had chosen a woman who had a measured response to him. Adam was scared not of sex but of his feelings for her. He wanted to nestle right in with her, to walk hand in hand, to stay close by. He was not used to straightforward affection like this; he was accustomed to drama, to seduction, to complication, to transgression. What frightened him now was the innocent and hopeful feel of their relationship.

"Can I trust myself, Doctor? Will I still feel the same way tomorrow? And the day after that?"

His concern about his ability to sustain loving feelings without the intrigue and the seesaw that were his signature was impressive. I felt encouraged. Knowing one's areas of difficulty goes a long way toward being able to renegotiate them.

Karen was a good match for him. She was not as afraid of intimacy as Adam was nor was she unpracticed at the long haul. Her husband, with whom she had had a good relationship, had died two years earlier. She and her six-year-old daughter were plodding along, trying to live between the cracks of their grief, surrounded by a supportive group of friends and family. Adam was a surprise to her. She had not thought that she was available for a new lover and perhaps it was her ability not to need him desperately and yet still be interested that enabled Adam to respond in a way that was fresh. They were caught up with each other excitedly rather than compulsively. He felt no desire to ravish her emotionally but just to lie with her, to talk with her and to play house with her and her daughter. They made love from a place so deep that he had not known it existed. Instead of the psychological and physical gymnastics he had employed before to reach into another, he now found himself effortlessly taken up with Karen. He did not need to fuck her as she had never been fucked before. Such a concept now jarred him. He lay with her, content, safe inside himself, safe with her and safe inside her.

They had a great half year together. Then Karen's daughter Jessie had an accident. It was a normal falling-off-your-bicycle-type of accident, except that Karen was not easily consoled. When Jessie was in the hospital, and during the physiotherapy treatments for her knee that followed, Karen was terribly distraught. She was deeply shaken, facing again the uncertainties of life. First she had lost a husband, now her daughter had hurt her leg. Karen's distress did not let up.

She leaned on Adam, who was at the ready with his heart and his shoulder. But he could not make Karen feel better and I could see how deeply this disturbed him. He had had his own private struggle when Jessie was first hurt and Karen had turned some of her attention away from him and toward Jessie. Despite his deep concern for the two of them, he felt abandoned. When Karen was spending all her time at the hospital, he found himself sauntering out of the kitchen to the bar of his restaurant to chat up some women, turning on his charm like a talent he had not used for a while. He was on automatic pilot seeking an old comfort. But within half an hour he felt wasted. He had been going through the motions of something that no longer landed him where he wanted to be. He discovered it was better to feel the loss of Karen than to create some diversion for himself.

Between two sessions Adam dreamed that Karen was leaving him. In the dream he watched as she went to his restaurant, emptied it of supplies, filched his recipes. He was confused and tormented. Why was she robbing him? It made no sense. The scene cut to her cooking his recipes and feeding an ailing aunt of his who had cancer. His aunt recovered. Karen said she would stay.

The dream startled Adam. This Karen was so out of character with Karen herself that he took his dream as a message from his own hinterland. Why was he viewing her as a marauder, he wondered. Why was she able to stay with him when she had healed his aunt?

The dream helped us understand what we had not emotionally been able to grasp before. We now had confirmation for our hunch that as a boy he had been prematurely turned into a little man, encouraged to make life better for his mother by solving her problems. His energy and exuberance had been hijacked to keep her going but she had not been able to replenish his stocks. In his attempt to find his own way he had become someone who could service and charm. But this self was unstable because it did not have many resources of its own. For refueling he plundered others as his mother had plundered him. He had made himself essential to them so that he was wanted and needed. Faced with being unable to console Karen and feeling abandoned by her, he was thrown. In his dream he had revisited the distress of his childhood and the patterns of relating that had been shaped between him and his mother. But he found that Karen had healing powers, she was not just the women thief who had, for so long, peopled his unconscious.

This realization excited him. He had chosen a woman who really nourished him and whom he would not discard. This knowledge sat alongside his frustration that he could not make things better for Karen. It was humbling and hard for him. He felt uneasy relinquishing the illusion that he could turn things around for her. Not that Karen was expecting him to make it all better. She was level-headed and knew he could not. She was staying with her hurt, asking for no more than his support.

At first he experienced her need for support as a demand and in part it was a demand but not the kind of demand he was used to. Karen needed him to be patient and present while she struggled with the limits of her own protectiveness. She was not as available t o him as before. But neither was she on the way out of the relationship. Adam had initially translated this difficult situation into the vernacular he knew for it resonated with his early abandonment by his father and his mother. When he felt dropped, he tried to still his anxiety by pillaging from the women at his bar. But it did not work. It made him feel worse. He moved back into himself and stayed with what he was actually feeling in order to manage the alarm that Karen's turn to her daughter had provoked in him.

His sensitivity to the dream and to the changes within him helped him accomplish the last piece of our work together. He learned to stand by while someone else was in pain, accompanying them through it but not fearing that he was being used. It made it possible for him and Karen to stay connected and close. He felt thwarted at not being able to repair the situation for her but he did not need to flee from her or from himself. He was now living his own emotional life and was quite able to deal with the real problems he encountered.

I returned to chopping the fennel, my mouth curving in a satisfied smile. What a whirlwind our journey had started with! How ephemeral all the erotic fantasizing had become and yet how absolutely crucial it turned out to have been to privately pursue what Adam had stimulated in me. In my engagement with what he, at that time, saw as the best of himself I came to understand the terror and bleakness at the heart of him. It gave me a view into where his difficulties lay.

I felt then, as I had often felt during our work together, that if his therapy had stopped midway, if I had been too frightened of the erotic feelings I was having or if he had walked away feeling misunderstood, that Adam would have been left, like many other men -- a few of whom I have known in my practice and more I have heard about through my woman patients -- a man bereft of himself. Men whose emptiness leads them to become psychological terrorists, feeding off the love they can produce for the women they romance and then drop. Men who have to play out and endlessly repeat the pursuit and vanquishing of others. Adam was no longer tied to that destiny. In facing the cold chill of his emptiness, he risked something more. His penis had led him away from a life that was no longer working into one that gave him more possibilities.

Copyright © 2000 by Susie Orbach

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Interviews & Essays

What would you like readers to take away from the experience of reading The Impossibility of Sex?

More than anything, I wanted to invite people into the experience of the consulting room: what goes on there, what it feels like, how what the patient says and the therapist says actually heals. I wanted to shatter the aura of mystery that surrounds the process of psychotherapy and convey instead how very moving, beautiful and profound it can be for both parties. Despite the TV drama The Sopranos and the feature film Analyze This, we know little about the therapist's work, how she or he goes about it, what they make of the people who consult them, why they do it, what challenges they face, how they deal with what the listen to, how they manage all the human suffering set before them. I wanted to present the therapist as she really is--a human being, whose reactions to her clients---fear, attraction, sorrow---are recognizable. At the same time, the therapist is a highly trained professional who is able to analyze her own emotional responses to her clients and to then use that information to learn more about the patient's emotional situation. It's really a fascinating and dynamic process, and most people don't have a sense of it.


You argue that privacy and confidentiality are crucial to the therapist-client relationship. Was it difficult to write a complete disclosure of this relationship from the therapist's point of view?

No. While during a therapy one doesn't tend to reveal what one is feeling and thinking, these stories were a chance to show the processes going on in the therapists mind and heart. One of the interesting things about the clinical situation is that clients come to have quite powerful feelings and fantasies about their therapists--even if they see them as a blank screen, that itself is interesting because it conjures up the view of a significant void that one is talking with. These feelings, the reality of them, where they come from are part of what therapy unravels. At the same time the feelings a client brings to the therapist can stir up things in the therapist who must sometimes even feel she is being asked to be someone she isn't. She can experience herself as an actor in a play of the patient's making. This emotional pressure on the therapist enables the therapist to see, feel and understand first hand something about what goes on for their patients in close relationships. The therapist's scrutiny of her own reactions to her patients forms the basis for some of the treatment.


In reference to the book's provocative title, have you ever become romantically involved with a client?

I have never become romantically involved with a client. The section about Adam describes one of the most intense interactions that can occur between therapist and patient. Fortunately, I've never had to deal with quite such a strong Cassanova in my practice but many colleagues have. That's not to say that I haven't experienced powerful feelings in regard to my clients. One of the purposes of therapy is for the client to uncover and discover the breadth and complexity of his or her emotions. So it's not surprising when this highly charged atmosphere spurs a response from the therapist. I don't think that romantic attraction necessarily jeopardizes the therapist-client relationship. But it can certainly be problematic.


Do themes from your book Fat is a Feminist Issue surface in this book?

Feminism has greatly influenced how we think about human needs in general. We know and value attachment and the struggle to express our needs for one another while maintaining a separate sense of self. So that while The Impossibility of Sex doesn't have an overtly feminist focus, it is completely informed by how feminism has affected all of our thinking over the last 25 years. It is true too that women today still face a unique set of issues with regard to psychotherapy. Although they will seek professional help it can make them uneasy to bring and show their vulnerabilities to another and have them addressed. They were brought up to place the needs of others before their own so that confronted with the chance to have their own as the number one agenda in therapy is both exciting and scary. Men too have particular issues around their vulnerability which I have also tried to show from a feminist perspective. In addition one of the stories about a man has as its focus food and body image.


You've certainly been asked a lot of questions about your relationship with Princess Diana. Without delving too deeply into this painful subject, is there anything you can say about your reaction to her death? Does she appear in the book in any way?

I know it sounds nuts but one of the things that a psychotherapist cannot really discuss at all is their feelings towards a patient. So although I recognize that there is a great fascination to discover something about the private inner life of Diana, or even for me to say what I thought about her or felt towards her life or her death, I think at the same time you would not expect me to share any of that. I think sometimes that we are fascinated in the private lives of our public figures because we are trying to work out whether they are human just like us. If they felt this or were like this or are all mangled up in such and such a way then we feel less isolated in ourselves. In the fragmented world in which we now live which is always expanding, public figures from Hollywood on down are a way of creating an emotional global village. They provide the links between people all over the world to be part of the human family. We are riveted by them because they connect us to one another. They give us an instant vocabulary, set of values and desires. In this sense then when we are eager to find out about Diana and whether she is in the book, we are eager to identify with her and find ourselves.


What aspect of therapy do you find most rewarding?

Gosh! That's hard. Obviously the privilege of entering other people's lives and being allowed to enable them to experience things in a new way. The fact that one can be very effective in helping people to feel that they are inhabiting their lives from the inside when they may have felt that they were all a jumble made up of disconnected parts. The issues I am challenged with on a weekly basis that keep me intellectually and emotionally on my toes. The chance to participate in and witness human ingenuity and creativity.

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